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低鈣血症低血鈣症(Hypocalcaemia)係指血清中的鈣離子濃度過低的狀況[5],正常比例為 2.1 至 2.6 mmol/L(約為 8.8 到 10.7mg/dl,4.3 到 5.2 mEq/L),如果低於 2.1 mmol/L,就會認定為低鈣血症[1][3][6],輕微的低鈣狀況通常進展很緩慢,而且沒有症狀[2][4],其他可能會有的症狀包含感覺遲鈍英语Paresthesia、肌肉痙攣癲癇發作、意識混亂、心跳停止[1][2]

低鈣血症
Hypocalcemia
同義詞 低血鈣症
Ca-TableImage.png
元素周期表中的鈣
醫學專科 內分泌學
症状 感覺遲鈍英语Paresthesia痙攣癲癇發作、意識混亂[1][2]
併發症 心搏停止[1][2]
肇因 副甲狀腺功能低下症英语hypoparathyroidism维生素D缺乏症腎功能衰竭胰腺炎鈣離子通道阻滯劑中毒横纹肌溶解症腫瘤溶解症候群英语tumor lysis syndrome雙磷酸鹽英语bisphosphonates[1][2]
診斷方法 血鈣 < 2.1 mmol/L(或是用校正鈣質或是游離鈣質計算)[1][3][2]
治療 維他命D硫酸镁補鈣劑英语Calcium supplement[1][2]
盛行率 佔住院比例的~18%[4]

常見的成因為罹患副甲狀腺功能低下症英语Hypoparathyroidism維生素D缺乏症[2],其他成因則包含了罹患腎功能衰竭胰腺炎橫紋肌溶解症腫瘤溶解症候群英语Tumor lysis syndrome鈣離子通道阻滯劑中毒,及服用特定藥劑如骨骼疏鬆藥雙磷酸鹽英语bisphosphonates[1]。診斷時需確認校正後的血鈣濃度(Corrected calcium)或游離鈣(ionized calcium)濃度[2],照心電圖或許有助於看出特殊變化[1]

症狀嚴重時的早期治療方法為靜脈並用注射氯化鈣硫酸鎂[1],其他療法則為施用維他命D補鈣劑英语Calcium supplement[2]。如果患者患有副甲狀腺功能低下症英语hypoparathyroidism,會推薦使用氫氯噻嗪磷結合劑英语phosphate binders以及採用低鈉飲食英语Low sodium diet[2]。在住院治療的人當中,約有 18% 的人有低鈣血症[4]

參考資料编辑

  1. ^ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 Soar, J; Perkins, GD; Abbas, G; Alfonzo, A; Barelli, A; Bierens, JJ; Brugger, H; Deakin, CD; Dunning, J; Georgiou, M; Handley, AJ; Lockey, DJ; Paal, P; Sandroni, C; Thies, KC; Zideman, DA; Nolan, JP. European Resuscitation Council Guidelines for Resuscitation 2010 Section 8. Cardiac arrest in special circumstances: Electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution.. Resuscitation. October 2010, 81 (10): 1400–33. PMID 20956045. doi:10.1016/j.resuscitation.2010.08.015. 
  2. ^ 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 Fong, J; Khan, A. Hypocalcemia: updates in diagnosis and management for primary care. Canadian Family Physician. February 2012, 58 (2): 158–62. PMC 3279267. PMID 22439169. 
  3. ^ 3.0 3.1 Pathy, M.S. John. Appendix 1: Conversion of SI Units to Standard Units. Principles and practice of geriatric medicine 2 4. Chichester [u.a.]: Wiley. 2006: Appendix. ISBN 9780470090558. doi:10.1002/047009057X.app01. 
  4. ^ 4.0 4.1 4.2 Cooper, MS; Gittoes, NJ. Diagnosis and management of hypocalcaemia. BMJ (Clinical Research Ed.). 7 June 2008, 336 (7656): 1298–302. PMC 2413335. PMID 18535072. doi:10.1136/bmj.39582.589433.be. 
  5. ^ LeMone, Priscilla; Burke, Karen; Dwyer, Trudy; Levett-Jones, Tracy; Moxham, Lorna; Reid-Searl, Kerry. Medical-Surgical Nursing. Pearson Higher Education AU. 2015: 237. ISBN 9781486014408. (原始内容存档于2016-10-02) (英语). 
  6. ^ Minisola, S; Pepe, J; Piemonte, S; Cipriani, C. The diagnosis and management of hypercalcaemia. BMJ (Clinical Research Ed.). 2 June 2015, 350: h2723. PMID 26037642. doi:10.1136/bmj.h2723. 

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