ozi

Sodium, potassium, calcium, bicarbonate, na nguzozi mmiri n'ime ọbara bụ ihe ndabere maka ịnọgide na-arụ ọrụ physiological n'ime ahụ. Enweghi nyocha banyere nsogbu ion magnesium. N'ihe dị ka afọ 1980, a maara magnesium dị ka "electrolyte echefuru echefu". Na nchoputa nke magnesium kpọmkwem ọwa na transporters, nakwa dị ka nghọta nke physiological na hormonal ụkpụrụ nke magnesium homeostasis, nghọta ndị mmadụ banyere ọrụ nke magnesium na-adakarị ọgwụ na-adịwanye omimi mgbe niile.

Magnesium dị mkpa maka ọrụ sel na ahụike. Magnesium na-adịkarị n'ụdị Mg2+, ọ dịkwa na sel niile nke ihe ndị dị ndụ, site na osisi ruo n'anụmanụ dị elu. Magnesium bụ ihe dị mkpa maka ahụike na ndụ, n'ihi na ọ bụ ihe dị mkpa na-akwado isi iyi ike ATP. Magnesium na-esonye na isi usoro physiological nke mkpụrụ ndụ site na ijikọ na nucleotides na ịhazi ọrụ enzyme. Mmeghachi omume ATPase niile chọrọ Mg2+- ATP, gụnyere mmeghachi omume metụtara ọrụ RNA na DNA. Magnesium bụ ihe na-akpata ọtụtụ narị mmeghachi omume enzymatic na sel. Na mgbakwunye, magnesium na-achịkwa glucose, lipid, na protein metabolism. Magnesium na-etinye aka n'ịhazi ọrụ neuromuscular, na-achịkwa ụda obi, ụda vaskụla, secretion hormone, na ntọhapụ nke N-methyl-D-aspartate (NMDA) na usoro nhụjuanya nke etiti. Magnesium bụ onye ozi nke abụọ na-etinye aka na nrịbama intracellular yana onye na-achịkwa mkpụrụ ndụ ihe nketa okirikiri nke na-achịkwa usoro okirikiri nke usoro ndu.

Enwere ihe dịka gram 25 nke magnesium n'ime ahụ mmadụ, nke a na-echekwa n'ime ọkpụkpụ na anụ ahụ dị nro. Magnesium bụ ihe dị mkpa intracellular ion na nke abụọ kasị ibu intracellular cation mgbe potassium. N'ime sel, 90% ruo 95% nke magnesium na-ejikọta na ligands dị ka ATP, ADP, citrate, protein na nucleic acid, ebe naanị 1% ruo 5% nke magnesium intracellular dị n'ụdị efu. Ntinye uche magnesium intracellular efu bụ 1.2-2.9 mg/dl (0.5-1.2 mmol/L), nke yiri ntinye uche nke extracellular. Na plasma, 30% nke magnesium na-ekesa na-ejikọta na protein tumadi site na acid fatty free. Ndị ọrịa nwere ogologo oge dị elu nke acid fatty free na-enwekarị mkpokọta magnesium dị ala, nke na-adaba na ihe ize ndụ nke ọrịa obi na ọrịa metabolic. Mgbanwe na acid fatty free, yana ọkwa EGF, insulin, na aldosterone, nwere ike imetụta ọkwa magnesium ọbara.

E nwere akụkụ atọ bụ isi na-achịkwa magnesium: eriri afọ (na-achịkwa absorption magnesium nri), ọkpụkpụ (na-echekwa magnesium n'ụdị hydroxyapatite), na akụrụ (na-achịkwa excretion nke magnesium urinary). A na-ejikọta usoro ndị a ma jikọta nke ọma, na-emekọ ọnụ na-akpụ axis akụrụ ọkpụkpụ, na-ahụ maka absorption, mgbanwe, na excretion nke magnesium. Mgbanwe nke magnesium metabolism nwere ike ibute nsonaazụ pathological na physiological

Nri bara ụba na magnesium gụnyere ọka, agwa, akị, na akwụkwọ nri akwụkwọ ndụ akwụkwọ ndụ (magnesium bụ ihe bụ isi nke chlorophyll). Ihe dị ka 30% ruo 40% nke nri magnesium na-eri nri na-abanye n'ime eriri afọ. Ọtụtụ nnabata na-apụta na eriri afọ nta site na njem intercellular, usoro na-agafe agafe nke metụtara njikọ siri ike n'etiti sel. Nnukwu eriri afọ nwere ike ịhazi nnabata magnesium nke ọma site na transcellular TRPM6 na TRPM7. Mwepu nke eriri afọ TRPM7 nke eriri afọ nwere ike iduga nhụsianya siri ike na magnesium, zinc, na calcium, nke na-emebi mmalite mmalite na ịlanarị mgbe amuchara nwa. A na-emetụta nnabata nke magnesium site na ihe dị iche iche, gụnyere oriri magnesium, uru pH intestinal, homonụ (dịka estrogen, insulin, EGF, FGF23, na hormone parathyroid [PTH]), na eriri afọ microbiota.
N'ime akụrụ, tubules gbasara akụrụ na-eweghachi magnesium site na ụzọ extracellular na intracellular. N'adịghị ka ọtụtụ ion dị ka sodium na calcium, ọ bụ nanị ntakịrị ego (20%) nke magnesium ka a na-emegharịghachi na tubules dị nso, ebe ọtụtụ (70%) nke magnesium na-emegharịghachi na loop Heinz. N'ime tubules dị nso na alaka ndị na-adịghị ahụkebe nke Heinz loop, ndọghachi azụ nke magnesium na-ebutekarị site na gradients itinye uche na ike akpụkpọ ahụ. Claudin 16 na Claudin 19 na-etolite ọwa magnesium n'ime alaka siri ike nke Heinz loop, ebe Claudin 10b na-enyere aka ịmepụta voltaji intraluminal dị mma n'ofe sel epithelial, na-ebugharị magnesium ion reabsorption. N'ime tubules distal, magnesium na-edozi nke ọma reabsorption intracellular (5% ~ 10%) site na TRPM6 na TRPM7 n'ọnụ ọnụ cell, si otú ahụ na-ekpebi njedebe ikpeazụ nke magnesium excretion.
Magnesium bụ akụkụ dị mkpa nke ọkpụkpụ, na 60% nke magnesium n'ime ahụ mmadụ na-echekwa n'ime ọkpụkpụ. Magnesium a na-agbanwe agbanwe n'ime ọkpụkpụ na-enye nchekwa dị ike maka idobe mkpokọta physiological plasma. Magnesium na-akwalite ọkpụkpụ ọkpụkpụ site na-emetụta ọrụ nke osteoblasts na osteoclasts. Ịba ụba oriri magnesium nwere ike ịbawanye ọdịnaya ịnweta ọkpụkpụ, si otú ahụ belata ihe ize ndụ nke mgbaji na osteoporosis n'oge ịka nká. Magnesium nwere ọrụ abụọ na nrụzi ọkpụkpụ. N'oge nnukwu oge nke mbufụt, magnesium nwere ike ịkwalite okwu TRPM7 na macrophages, mmepụta cytokine na-adabere na magnesium, ma kwalite microenvironment na-adịghị ahụkebe nke ọkpụkpụ ọkpụkpụ. N'oge oge ngbanwe nke ọgwụgwọ ọkpụkpụ, magnesium nwere ike imetụta osteogenesis ma gbochie mmiri ozuzo hydroxyapatite. TRPM7 na magnesium na-ekerekwa òkè na usoro nhazi nke vaskụla vaskụla site na imetụta mgbanwe nke mkpụrụ ndụ anụ ahụ dị nro na-egbuke egbuke na osteogenic phenotype.

Nleba anya nke magnesium n'ọbara na ndị okenye bụ 1.7 ~ 2.4 mg / dl (0.7 ~ 1.0 mmol / L). Hypomagnesemia na-ezo aka na serum magnesium n'okpuru 1.7 mg / dl. Ọtụtụ ndị ọrịa nwere oke hypomagnesemia enweghị akara ngosi doro anya. N'ihi ohere nke ụkọ magnesium nwere ike ịdị ogologo oge na ndị ọrịa nwere ọkwa magnesium dị elu karịa 1.5 mg / dl (0.6 mmol/L), ụfọdụ na-atụ aro iwelite ọnụ ala dị ala maka hypomagnesemia. Otú ọ dị, ọkwa a ka na-arụrịta ụka ma na-achọ nkwenye ụlọ ọgwụ ọzọ. 3% ~ 10% nke ndị mmadụ n'ozuzu ha nwere hypomagnesemia, ebe ọnụọgụ nke ụdị ọrịa shuga 2 (10% ~ 30%) na ndị ọrịa nọ n'ụlọ ọgwụ (10% ~ 60%) dị elu karị, karịsịa na ndị ọrịa na-ahụ maka nlekọta ahụ ike (ICU), nke ọnụ ọgụgụ ya karịrị 65%. Otutu ọmụmụ ihe egosila na hypomagnesemia jikọtara ya na ihe ize ndụ dị ukwuu nke ọnwụ na-akpata ọnwụ na ọrịa obi na-akpata ọrịa obi.

Ngosipụta ụlọ ọgwụ nke hypomagnesemia na-agụnye mgbaàmà ndị na-abụghị nke a kapịrị ọnụ dị ka iro ụra, spasms muscle, ma ọ bụ adịghị ike nke anụ ahụ nke kpatara erighị ihe oriri na-ezuru oke, ịba ụba nke eriri afọ, mbelata reabsorption renal, ma ọ bụ redistribution nke magnesium site n'èzí gaa n'ime sel (Nyocha 3B). Hypomagnesemia na-ebikọkarị n'ọrịa electrolyte ndị ọzọ, gụnyere hypocalcemia, hypokalemia, na metabolic alkalosis. Ya mere, enwere ike ileghara hypomagnesemia anya, karịsịa n'ọtụtụ ebe a na-agwọ ọrịa ebe a na-adịghị atụle ọkwa magnesium n'ọbara. Ọ bụ naanị na hypomagnesemia siri ike (serum magnesium <1.2 mg / dL) [0.5 mmol/L]), ihe mgbaàmà dị ka ihe na-adịghị mma neuromuscular excitability (nkwụsị ụkwụ nkwojiaka, Akwụkwụ na-adọ, na ịma jijiji), ọrịa obi (arrhythmias na vasoconstriction), na nsogbu nke metabolic (insulin resistance na cartilageent applicement). A na-ejikọta Hypomagnesemia na ịba ụba ụlọ ọgwụ na ọnụ ọgụgụ ndị na-anwụ anwụ, karịsịa mgbe hypokalemia na-esonyere ya, na-akọwapụta mkpa ahụike nke magnesium.
Ọdịnaya magnesium dị n'ọbara na-erughị 1%, yabụ ọdịnaya magnesium n'ọbara enweghị ike igosipụta oke ọdịnaya magnesium n'ime anụ ahụ. Nchọpụta egosila na ọ bụrụgodị na ọbara magnesium na-eme ka ọ dị mma, ọdịnaya magnesium intracellular nwere ike ibelata. Ya mere, ịtụle naanị ọdịnaya magnesium dị n'ọbara na-echeghị ihe oriri magnesium na-eri nri na mfu mmamịrị nwere ike ileda ụkọ magnesium ụlọ ọgwụ anya.

Ndị ọrịa nwere hypomagnesemia na-enwekarị hypokalemia. A na-ejikọkarị hypokalemia isi ike na ụkọ magnesium, yana enwere ike idozi ya nke ọma naanị mgbe ọkwa magnesium laghachiri na nkịtị. Enweghị ụkọ Magnesium nwere ike ịkwalite nzuzo nke potassium site na ducts na-anakọta, na-eme ka mfu potassium dịkwuo njọ. Mbelata nke ọkwa magnesium intracellular intracellular na-egbochi ọrụ Na + - K +- ATPase ma na-abawanye oghere nke ọwa potassium medullary extrarenal (ROMK), na-eduga na mfu potassium karịa na akụrụ. Mmekọrịta dị n'etiti magnesium na potassium gụnyekwara ịgbalite sodium chloride co transporter (NCC), si otú ahụ na-akwalite nnabata sodium. Enweghị ụkọ Magnesium na-ebelata ụbara NCC site na E3 ubiquitin protein ligase a na-akpọ NEDD4-2, nke na-ebelata mmepe nke cell neuronal precursor, ma na-egbochi ọrụ NCC site na hypokalemia. Mbelata nke NCC na-aga n'ihu nwere ike ịkwalite mbufe Na + dị anya na hypomagnesemia, na-eduga n'ịba ụba nke potassium na mmamịrị na hypokalemia.

Hypocalcemia na-adịkarị na ndị ọrịa nwere hypomagnesemia. Enweghị Magnesium nwere ike igbochi ntọhapụ nke hormone parathyroid (PTH) ma belata mmetụta nke akụrụ na PTH. Mbelata nke ọkwa PTH nwere ike ibelata renal calcium reabsorption, mụbaa excretion nke calcium nke urinary, ma mesịa bute hypocalcemia. N'ihi hypocalcemia nke hypomagnesemia kpatara, hypoparathyroidism na-esikarị ike idozi ma ọ bụrụ na ọkwa magnesium ọbara alaghachila na nkịtị.

Serum mkpokọta magnesium n'ihe bụ usoro ọkọlọtọ maka ịchọpụta ọdịnaya magnesium na omume ụlọ ọgwụ. Ọ nwere ike nyochaa ngwa ngwa mgbanwe dị mkpirikpi na ọdịnaya magnesium, mana ọ nwere ike ileda mkpokọta magnesium n'ime ahụ anya. Ihe endogenous (dị ka hypoalbuminemia) na exogenous ihe (dị ka ihe atụ hemolysis na anticoagulants, dị ka EDTA) nwere ike imetụta nha nha nke magnesium, na ihe ndị a kwesịrị ka a tụlee mgbe ị na-akọwapụta nsonaazụ ule ọbara. Enwere ike tụọ magnesium serum ionized, mana ọrụ ọgwụgwọ ya amabeghị.
Mgbe ị na-achọpụta hypomagnesemia, a na-ekpebikarị ihe kpatara ya dabere na akụkọ ahụike onye ọrịa. Otú ọ dị, ọ bụrụ na ọ dịghị ihe doro anya kpatara ya, ọ dị mkpa iji ụzọ nchọpụta kpọmkwem iji chọpụta ma ọ bụ akụrụ ma ọ bụ eriri afọ na-akpata ọnwụ magnesium, dị ka nsị magnesium nke awa 24, akụkụ nke magnesium excretion, na ule magnesium.

Ihe mgbakwunye magnesium bụ ntọala maka ọgwụgwọ hypomagnesemia. Otú ọ dị, ugbu a enweghị usoro ọgwụgwọ doro anya maka hypomagnesemia; Ya mere, usoro ọgwụgwọ na-adabere karịsịa n'ịdị njọ nke mgbaàmà ụlọ ọgwụ. Enwere ike ịgwọ hypomagnesemia dị nro site na mgbakwunye ọnụ. Enwere ọtụtụ nkwadebe magnesium n'ahịa, nke ọ bụla nwere ọnụego nnabata dị iche iche. Anụ ahụ mmadụ na-abanye n'ahụ mmadụ n'ụzọ dị mfe karịa nnu inorganic (dị ka magnesium chloride, magnesium aspartate, magnesium glycine, magnesium glycine, na magnesium oxide). Mmetụta dị n'akụkụ ihe mgbakwunye magnesium ọnụ bụ afọ ọsịsa, nke na-ebute ihe ịma aka maka mgbakwunye magnesium ọnụ.
Maka okwu mgbagha, ọgwụgwọ ọgwụ adjuvant nwere ike ịdị mkpa. Maka ndị ọrịa nwere ọrụ akụrụ nkịtị, igbochi ọwa sodium epithelial nwere aminophenidate ma ọ bụ triaminophenidate nwere ike ịbawanye ọkwa magnesium serum. Usoro ndị ọzọ nwere ike ịgụnye iji SGLT2 inhibitors na-abawanye ọkwa magnesium serum, karịsịa na ndị ọrịa nwere ọrịa shuga. Usoro ndị na-akpata mmetụta ndị a amabeghị nke ọma, mana ha nwere ike ịmetụta mbelata nke nzacha glomerular na mmụba nke reabsorption renal tubular. Maka ndị ọrịa nwere hypomagnesemia bụ ndị na-adịghị arụ ọrụ na ọgwụgwọ mgbakwunye magnesium ọnụ, dị ka ndị nwere ọrịa bowel mkpụmkpụ, aka na ụkwụ ụkwụ, ma ọ bụ Akwụkwụ na-adọ, yana ndị nwere nsogbu hemodynamic kpatara arrhythmia, hypokalemia, na hypocalcemia, a ga-eji ọgwụgwọ intravenous mee ihe. Enwere ike imeziwanye hypomagnesemia nke PPI kpatara site na nchịkwa ọnụ nke inulin, yana usoro ya nwere ike jikọta na mgbanwe na microbiota eriri afọ.

Magnesium bụ ihe dị mkpa mana a na-elegharakarị electrolyte anya na nyocha ụlọ ọgwụ na ọgwụgwọ. A naghị anwale ya dị ka electrolyte nke a na-ahụkarị. Hypomagnesemia anaghị enwekarị akara ngosi. Ọ bụ ezie na kpọmkwem usoro a na-ahazi nguzozi magnesium n'ime ahụ ka edobeghị anya, enweela ọganihu na nyocha nke usoro nke akụrụ na-esi na magnesium. Ọtụtụ ọgwụ nwere ike ibute hypomagnesemia. Hypomagnesemia bụ ihe a na-ahụkarị n'etiti ndị ọrịa nọ n'ụlọ ọgwụ yana ihe dị ize ndụ maka ọnụnọ ICU ogologo oge. Ekwesịrị mezie hypomagnesemia n'ụdị nkwadebe nnu organic. Ọ bụ ezie na a ka nwere ọtụtụ ihe omimi ka a ga-edozi banyere ọrụ magnesium na ahụike na ọrịa, enweela ọganihu dị ukwuu na mpaghara a, ndị dọkịta na-ahụ maka ahụike kwesịrị ileba anya na mkpa magnesium dị na nkà mmụta ọgwụ.