Study On The Relationship Between The Level Of Magnesium Ion And The Severity Of Liver Cirrhosis

Objective: To detect the level of magnesium ion in patients with liver cirrhosis and to explore the relationship between the level of magnesium ion and the severity of liver cirrhosis.Method:A total of 330 inpatients were selected from January 2016 to December 2019 in the first affiliated Hospital of Jishou University,including 237 males and 93 females,201 patients with total low magnesium.There were 211 patients with hepatitis B cirrhosis and 109 patients with low magnesium.There were 104 cases of alcoholic liver cirrhosis and 82 cases of low magnesium.There were 15 patients with autoimmune cirrhosis and 10 patients with low magnesium.Among the cirrhosis groups with different etiologies,77 patients in the Child-Pugh A group were scored according to the Child-Pugh grading standard,including 31 patients with low magnesium.Child-Pugh group B,a total of 165 patients were enrolled,including 102 patients with low magnesium.There were 88 patients in Child-Pugh group C,including 68 patients with low magnesium.Hepatitis B cirrhosis group was scored according to Child-Pugh grading standard,A total of 56 patients were in Child-Pugh group A,including 19 patients with low magnesium.Child-Pugh group B,a total of100 patients,55 patients with low magnesium.There were 55 patients in Child-Pugh group C,including 35 patients with low magnesium.In alcoholic cirrhosis group,according to Child-Pugh grading standard,there were 19 patients in Child-Pugh A group and 11 patients with low magnesium.In Child-Pugh B group,there were 55 patients and 41 patients with low magnesium;There were 30 patients in Child-Pugh group C,including 30 patients with low magnesium.In the autoimmune cirrhosis group,according to the Child-Pugh grading standard,there were 2 patients in the Child-Pugh A group,including 1 patient with low magnesium;There were 10 patients in Child-Pugh group B,including 6 patients with low magnesium;There were 3patients in Child-Pugh group C,including 3 patients with low magnesium.According to the Meld grading standard,there were 226 patients in the low risk group according to Meld score in the cirrhosis group with different etiology,including 126 patients with low magnesium;According to Meld score,there were 56 patients in medium risk group and 39 patients with low magnesium;There were 48 patients with high risk of Meld score and 36 patients with low magnesium.The hepatitis B cirrhosis group was scored according to the Meld grading standard.A total of 127 patients were included in the Meld low-risk group,including 52 patients with low magnesium;There were 44 patients in middle risk group and 29 patients with low magnesium according to Meld score;There were 40 patients with high risk of Meld score and 28 patients with low magnesium.Alcoholic cirrhosis was scored according to Meld grading standard,and there were 88 patients in the Meld low-risk group,including 67 patients with low magnesium;According to Meld score,there were 10 patients in medium risk group and 9 patients with low magnesium;There were 6 patients in the Meld high-risk group,including 6 patients with low magnesium.The autoimmune cirrhosis group was scored according to the Meld grading standard.There were 11 patients in the Meld low-risk group,including 7 patients with low magnesium;According to Meld score,there were 2 patients in medium risk group and 1 patient with low magnesium;There were 2 patients with high risk of Meld score,including 2 patients with low magnesium.Collect activated partial prothrombin time(APTT)and prothrombin time(PT)in blood coagulation routine;Total bilirubin(TBIL),albumin(ALB),alanine aminotransferase(ALT),aspartate aminotransferase(AST)in liver function;Hepatitis B virus markers and HBV-DNA in serum.Result:(1)、 The incidence of hypomagnesemia in hepatitis B cirrhosis group,alcoholic cirrhosis group and autoimmune cirrhosis group was 51.6%,78.8% and 66.6%,respectively.Compared with hepatitis B cirrhosis group and autoimmune cirrhosis group,magnesium deficiency in alcoholic cirrhosis group is more serious.There were significant differences in serum magnesium levels between alcoholic cirrhosis group and hepatitis B cirrhosis group and between hepatitis B cirrhosis group and autoimmune cirrhosis group(P <0.05).There was no significant difference between alcoholic cirrhosis group and autoimmune cirrhosis group(P >0.05).(2)、The higher the Meld score and Child-Pugh score,the higher the incidence and deficiency of hypomagnesemia in different etiological cirrhosis groups;There was statistical significance(P < 0.05).(3)、The higher the Meld score and Child-Pugh score,the higher the incidence and deficiency of hypomagnesemia in hepatitis B cirrhosis group.Among the patients with hepatitis B cirrhosis,there were significant differences between Child A group and Child B group,Child A group and Child C group(P <0.05);There was no significant difference between Child B group and Child C group(P >0.05).There were significant differences between low risk group and high risk group,low risk group and medium risk group(P <0.05);There was no significant difference between the middle risk group and the high risk group(P >0.05).(4)、 The higher the Child-Pugh score,the higher the incidence and deficiency of hypomagnesemia in alcoholic cirrhosis group.There was no significant difference between Child A group and Child B group,Child B group and Child C group,Child A group and Child C group.(5)、There was no correlation between Meld score and alcoholic liver cirrhosis.In alcoholic cirrhosis group,there was no significant difference between low-risk group and high-risk group,low-risk group and medium-risk group,middle-risk group and high-risk group(P > 0.05).(6)、There was no correlation between magnesium ion and Meld score and Child-Pugh score in autoimmune cirrhosis.(7)、There was a correlation between serum magnesium and various indexes of liver function.There was a positive correlation between serum magnesium and serum albumin(ALB),and a negative correlation between serum magnesium and total bilirubin.(8)、 Among the complications associated with liver cirrhosis,the level of serum magnesium in patients with liver cirrhosis treated with diuretics was lower than that in patients without diuretics(P <0.05).The level of serum magnesium in cirrhotic patients with gastrointestinal bleeding was lower than that in patients without gastrointestinal bleeding(P <0.05).There was no significant correlation between magnesium level and the use of lactulose(P =0.665)、infection(P =0.389)、hepatic encephalopathy(P =0.929)and ascites(P =0.934),respectively.Conclusion:1.Hypomagnesemia is more common in hepatitis B cirrhosis group,alcoholic cirrhosis group and autoimmune cirrhosis group.The lack of hypomagnesema in alcoholic cirrhosis group is more serious than that in hepatitis B cirrhosis group and autoimmune cirrhosis group.2.In patients with liver cirrhosis,the level of serum magnesium decreased with the increase of Child-Pugh score and Meld score;The serum magnesium decreased gradually with the severity of liver cirrhosis.3.In patients with hepatitis B cirrhosis,the level of serum magnesium decreased with the increase of Child-Pugh score and Meld score;The serum magnesium gradually decreased with the severity of hepatitis B cirrhosis.4.Serum magnesium was positively correlated with albumin and negatively correlated with total bilirubin.In patients with liver cirrhosis,the levels and indexes of total bilirubin,albumin and magnesium can be used as observation indexes to evaluate the recovery of the disease.5.Serum magnesium ion is related to gastrointestinal bleeding and the use of diuretics.