慢性心衰按比例口服呋噻米和螺内酯对血钾的影响

Influence of Oral Treatment with Furosemide and Spironolactone in Different Ratio on the Serum Potassium Level in Patients with Chronic Heart Failure

目的探讨慢性心力衰竭患者不同剂量呋噻米与螺内酯按比例联合应用对血钾水平的影响。方法选取2007年6月至2012年7月间从化市中心医院心内科住院慢性心力衰竭患者104例,随机均分为A、B两组,每组各50例。两组患者均在常规抗心衰治疗基础上给予排钾利尿剂呋噻米和保钾利尿剂螺内酯联合治疗。A、B两组呋噻米与螺内酯口服剂量比例分别为l∶l,l∶2,并排除饮食、肾功能、基础血钾对血钾的影响,监测血钾及血肌酐,统计比较两组低血钾发生率和高血钾发生率。结果 A、B两组低血钾发生率分别为71.2%、3.8%(P<0.01,χ2=50.26),高血钾发生率分别为0%、0%,B组对血钾水平影响较小。结论正常饮食、肾功能正常、基础血钾正常的慢性心衰患者口服呋噻米与螺内酯的比例为1∶2时对血钾水平的影响较小,适合长期治疗。

Objective To investigate the influence of combined applications of different dose of furosemide and spironolactone in different ratio on the serum potassium level in patients with chronic heart failure. Methods A total of 104 patients with Chronic heart failure, who were hospitalized in the department of cardiovascular internal medicine, Conghua central hospital were randomly divided into two groups （group A and group B）, and received combined treatment with furosemide （potassium-depleting diuretics） and spironolactone （potassium-sparing diuretics） beside conventional therapy of heart failure. Patients in group A and group B took orally furosemide and spironolactone according to the dosage ratio of 1 ： 1, 1 ： 2 respectively. With xcluding of the interference of diet, renal function and the basic serum potassium level on the serum potassium level, serum potassium level and serum creatinine were monitored and compared between group A and group B. Results The occurrence rate ofhypokalemia in group A, group B was 71.2%, 3.8% respectively （P〈0.01, χ2 = 50.26）, and incidence of hyperkalemia in group A, group B were 0% equally. The influence on serum potassium level in group A was less in group B. Conclusions Under condition of normal diet, normal renal function and the normal serum potassium level, the influence on serum potassium level is lower when the patients with chronic heart failure took orally furosemide and spironolactone ratio is 1 ： 2. And it is suitable for long-term treatment.