不同剂量利尿剂联合应用对心衰患者血钾的影响

Influence of combined applications of different diuretics in varied dose on serum potassium level in patients with heart failure

目的:探讨不同剂量排钾与保钾利尿剂联合应用对血钾含量的影响。方法:选取我院住院心衰患者642例,随机均分为A、B、C三组,均在常规心衰治疗基础上给予排钾利尿剂呋塞米,和保钾利尿剂螺内酯联合治疗,A、B、C三组呋塞米与螺内酯口服剂量比例分别为1:1,1:2,1:3,并排除饮食,肾功,基础血钾对血钾的干扰,监测血钾含量及肾功。结果:A、B、C三组低血钾发生率分别为75.2%,1.4%,0%(P<0.005,x2=416.78),高血钾发生率分别为0%,0%,21.0%(P<0.005,x2=96.78),以B组(呋塞米与螺内酯比例1∶2)对血钾影响最小。结论:在正常饮食、肾功,基础血钾情况下,呋塞米与螺内酯1∶2联合应用对血钾含量影响最小。

Objective：To investigate the influence of combined application of preservative potassium and exclusive potassium diuretic in varied dose on serum potassium level.Methods：A total of 642 patients with heart failure were collected from our hospital.They were randomly equally divided into A,B and C group,and received combined treatment of furosemide and spironolactone beside conventional therapy of heart failure.Patients in A、B、C three groups took furosemide and spironolactone orally according to the dosage ratio of 1 vs.1,1 vs.2 and 1 vs.3 respectively.Interruptions on serum potassium level were eliminated,including diet,renal function and basic level of serum potassium.Serum potassium level and renal function were monitored throughout the study.Results：The occurrence rates of hypokalemia in A,B and C group were 75.2%,1.4% and 0% respectively（P〈0.005,x2=416.78）,and incidence rates of hyperkalemia in A,B and C group were 0%,0% and 21.0% respectively（P〈0.005,x2=96.78）,the influence on serum potassium level is minimum in group B.Conclusion：Combined applications of different kinds of diuretics in varied dose have different effects on serum potassium level.Under condition of normal diet,renal function and basic level of serum potassium,the influence on serum potassium level is minimum when furosemide and spironolactone ratio is 1 vs.2.