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作者研究了一组环胞霉素(CyA)治疗期有神经异常的同种骨髓移植受体的血清镁水平,发现CyA神经毒性与低镁血症有关,补充镁剂可治疗或预防该并发症。 12例患者,男性7例、女性5例,年龄13—35岁。其中急性非淋巴细胞白血病7例、慢性粒细胞白血病3例和非何杰金氏淋巴瘤2例,均因同种骨髓移植而应用CyA,开始用了3mg/kg/天静注或12.5mg/kg/天口服(分2次),其后调整剂量使CyA血清浓度为200—400ng/ml。全部患者每周检测血清的镁水平。结果,患者可分为三组:(1)癫痫大发作7例,发生于CyA治疗头几周(中位数12天),发作时均右低镁血症(0.56±0.08,正常对照值为0.77±0.06mmol/l),且血清镁于发病前1—3周内即很快下降。于首次发作后均用抗癫痫药治疗,5例停用
The authors studied the serum magnesium levels of a group of allograft recipients with neurological abnormalities during the CyA regimen and found that neurotoxicity of CyA was associated with hypomagnesemia and that supplemental magnesium could treat or prevent the complications . Twelve patients, 7 males and 5 females, aged 13-35 years. Among them, 7 cases of acute non-lymphocytic leukemia, 3 cases of chronic myeloid leukemia and 2 cases of non-Hodgkin’s lymphoma were all treated with CyA by allogeneic bone marrow transplantation and started intravenous injection of 3mg / kg / day or 12.5mg / kg / day oral (2 times), after which the dose is adjusted so that CyA serum concentration is 200-400ng / ml. All patients were tested weekly for serum magnesium levels. As a result, the patients were divided into three groups: (1) 7 cases of epileptic seizures occurred in the first few weeks of CyA treatment (median 12 days), all of them had right hypomagnesemia (0.56 ± 0.08, normal control value 0.77 ± 0.06mmol / l), and serum magnesium decreased sharply within 1-3 weeks before onset. After the first attack were treated with antiepileptic drugs, 5 cases disabled