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低镁血症的病因

Author
Alan S L Yu, MB, BChir
Section Editor
Stanley Goldfarb, MD
Deputy Editor
John P Forman, MD, MSc
Translators
李萍, 主任医师

引言

低镁血症是一种常见疾病，发生于高达12%的住院患者[1]。在重症治疗情况下的患者中，低镁血症的发生率可升至高达60%-65%，在这种情况下，营养、利尿剂、低白蛋白血症和氨基糖苷类抗生素可能起到重要的作用[2-5]。在镁缺乏时，肾脏可将镁排泄减至很低的水平；血浆镁浓度下降时会刺激该反应发生。 (参见“镁平衡调节”)

低镁血症的发生有2个主要机制：经胃肠道丢失或肾脏丢失 (表 1)。不论是何种病因，在出现相对较少量的镁缺乏后，就会开始发生低镁血症，这是因为细胞外镁几乎不能与储量大得多的骨骼和细胞镁进行快速交换。

低镁血症通常伴有低钾血症(因为尿钾丢失)和低钙血症[因为甲状旁腺激素(parathyroid hormone, PTH)分泌减少和终末器官对PTH作用的抵抗]。 (参见“镁缺乏的临床表现”)

本专题将总结低镁血症的主要病因。镁平衡的调节、低镁血症的症状和体征，以及低镁血症患者的评估和治疗参见其他专题。 (参见“镁平衡调节”和“镁缺乏的临床表现”和“低镁血症的评估和治疗”)

胃肠道丢失

胃肠道分泌物含有部分镁，潜在丢失是持续存在且不被调节的。尽管必要的丢失并不多，但在明显的膳食缺乏时会出现进行性镁丢失。

                   

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Literature review current through: 2017-06 . | This topic last updated: 2016-02-04.
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