Akut İnmede Risk Faktörü ve Prognoz Üzerine Etkisi ile Magnezyum
Amaç: Serebrovasküler olay önemli bir morbidite ve mortalite nedenidir. Serebrovasküler hastalıklarındeğiştirilebilen nedenlerinin belirlenmesi serebrovasküler olayın engellenmesi ve/veya morbidite ve mortaliteninazaltılmasında önem arz etmektedir.Magnezyumun hayvan modellerinde nöroproteksiyon sağladığına dair kanıtlar olsa da, serebrovasküler olay sırasındamagnezyum etkinliğine dair sınırlı klinik kanıt bulunmaktadır.Bu çalışma ile serebrovasküler olayda magnezyumun değiştirilebilir bir risk faktörü olarak değerlendirilmesi vemortalite üzerine etkisinin olup olmadığının araştırılması planlandı.Yöntemler: Retrospektif olan çalışmamıza 1203 hasta dahil edildi. Hastalar serebrovasküler olay ve kontrol olmaküzere 2 gruba ayrıldı. Hastaların magnezyum düzeyleri yatışın birinci gününde ölçüldü. Çalışmaya hastaların yaşı,cinsiyeti, serum magnezyum düzeyi, hipertansiyon/diyabet varlığı ve hastaların son durumu dahil edildi.Bulgular: Hastaların %52,7’si erkek, %47,3’ü kadındı. Serebrovasküler olay grubunda E/K:0.94 olarak bulundu.Serebrovasküler olayın %26,7’si hemorajik serebrovasküler olay, %73,3’ü iskemik serebrovasküler olay olarak takipedilmiştir. Kontrol grubu ortalama serum magnezyum düzeyi 2,28 mg/dL, serebrovasküler olay grubu için ortalama1,87 mg/dL’ydi. Kontrol grubunda diyabet oranı %5,6, serebrovasküler olay grubunda diyabet oranı %11,5 olaraksaptanmıştır. Kontrol grubunda hipertansiyon oranı %54,8, serebrovasküler olay grubunda hipertansiyon oranı%60,9 olarak saptanmıştır. Kontrol grubunda mortalite oranı %1,6 iken serebrovasküler olay grubunda mortaliteoranı %20,8 olarak bulunmuştur.Sonuç: Serebrovasküler olay hastalarında erkek cinsiyet oranının literatürlerden düşük, hemorajik serebrovaskülerolay oranının literatürlerden yüksek olarak saptanması dikkat çekici bir özellikti. Düşük serum magnezyum düzeyininserebrovasküler olay için bir risk faktörü olabileceği ancak tek başına mortalite üzerine etkisi olmadığı gözlenmiştir.Diyabetes mellitus ve hipertansiyonun serum magnezyum ile ilişkisinin olmaması, serebrovasküler olay hastalarındamortalitenin literatürlerden düşük oranda saptandığı elde edilen diğer verilerdir.
Magnesium as a Risk Factor and Impact on Survey in Acute Stroke
Objective: Cerebrovascular events are major causes of mortality and morbidity. Determining the changeable causes of cerebrovascular diseases are important to prevent cerebrovascular diseases and/or reduce morbidity and mortality. Although there is evidence that magnesium provides neuroprotection in animal models, there is limited clinical evidence of magnesium effectiveness during cerebrovascular diseases. The aim of this study was to evaluate magnesium as a modifiable risk factor at cerebrovascular events and to investigate whether there is an effect of magnesium on mortality or not. Method: 1203 cases were included into this retrospective study. The cases were divided in two categories named cerebrovascular diseases and control group. The magnesium levels of the cases were measured on the first day of hospitalization. The age, gender, serum magnesium level, final state of the cases and the hypertension / diabetes conditions were included in the study. Results: 52.7% of the cases were male and 47.3% were female. In the cerebrovascular diseases group, M/F ratio was found to be 0.94. 26.7% of the cerebrovascular events were followed by hemorrhagic cerebrovascular event and 73.3% were followed up as ischemic cerebrovascular event. The mean magnesium level of the serum for control group was 2.28 mg/dL and the mean magnesium level of the serum for cerebrovascular events group was 1.87 mg/dL. Diabetes mellitus was found to be 5.6% for the control group and 11.5% for the cerebrovascular events group. Hypertension was found to be 55.8% for the control group and 60.9% for the cerebrovascular events group. Mortality rate was found to be 1.6% for the control group and 20.8% for the cerebrovascular events group. Conclusions: It is remarkable that, in our study male sex ratio is fewer than the literature for cerebrovascular events cases, and male sex ratio is higher than the literature for hemorrhagic cerebrovascular cases. Low serum magnesium level is detected to be a possible risk factor for cerebrovascular events, Whereas it does not have any affect on mortality by itself. The lack of relationship among diabetes mellitus and hypertension with magnesium, and the lower rate of mortality than literature in patients with cerebrovascular diseases are the other data obtained in our study.
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