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报道1例出生40 d患有严重的低镁血症和继发性低血钙的女婴,全身有惊厥发作,不发热,实验室检查显示,该患儿轻度甲状旁腺机能减退,镁治疗后甲状旁腺机能正常,肾排镁正常。患儿在原发性低镁血症确诊后出院,口服亚碳酸镁,肌肉注射硫酸镁。定期随访至4岁,该儿童无临床症状出现。血清钙平均值正常,而血清镁平均值仍低于正常值。在4年期间,口服镁的剂量逐渐增加,而胃肠外给镁的剂量和次数减少。因为亚碳酸镁有副作用,口服的亚碳酸镁转换成柠檬酸镁。当口服镁的剂量达到90 mg/(kg·d)柠檬酸镁,没有任何胃肠副作用时,停止胃肠外给镁。为了解慢性低镁血症的并发症,做相关的检查,结果显示,骨龄、骨密度测定、ECG和肾超声检查全部正常。现在患儿已5岁,没有再次发病。结论显示,口服大剂量镁进行治疗,成功使患者保持无症状且血钙正常,但血清镁浓度没有完全正常。因此,定期随访原发性低镁血症患者时,主要是增加口服镁的剂量,使血钙保持正常,而不是维持血镁正常。
Reported a 40-day-old baby with severe hypomagnesemia and secondary hypocalcemia who had seizures and no fever. Laboratory tests showed mild hypoparathyroidism and magnesium Parathyroid function after treatment, normal renal magnesium row. Children with primary hypomagnesemia were diagnosed after discharge, oral magnesium carbonate, intramuscular injection of magnesium sulfate. Regular follow-up to 4 years of age, the child no clinical symptoms appear. Mean serum calcium normal, and mean serum magnesium is still lower than normal. Over a 4-year period, the dose of oral magnesium gradually increased while the dose and frequency of parenteral magnesium decreased. Because of the side effects of magnesium carbonate, the oral magnesium carbonate is converted to magnesium citrate. When oral magnesium dose reached 90 mg / (kg · d) of magnesium citrate, without any gastrointestinal side effects, stop parenteral magnesium. In order to understand the complications of chronic hypomagnesemia, do related tests, the results showed that bone age, bone mineral density determination, ECG and renal ultrasound were all normal. Now the child has 5 years old, no recurrence. Conclusion: Oral administration of high-dose magnesium resulted in the patient remaining asymptomatic with normal serum calcium, but serum magnesium concentrations were not completely normal. Therefore, regular follow-up of primary hypomagnesemia patients, the main is to increase the dose of oral magnesium, to maintain normal serum calcium, rather than to maintain normal blood magnesium.