老年2型糖尿病患者并发低钾血症的临床探讨

The Clinical Exploration of Hypokalemia in Older Patients with Type 2 Diabetes Mellitus

目的探讨老年糖尿病患者并发低钾血症的临床特征,易发病原因及处理方法。方法对115例60周岁以上老年2型糖尿病患者并发低血钾病例资料进行回顾性研究,分析其病因及临床特点。结果 115例患者中以轻中度低钾患者103例(89.5%)为主,含钾食物摄入不足及治疗药物副反应所致低钾为老年糖尿病患者不容忽视的主要原因。Spearman相关分析提示血钾水平与糖化血红蛋白(r=-0.318,P<0.05)及合并其他疾患数目(r=-0.406,P<0.05)呈反比。结论老年糖尿病患者因长期血糖控制不理想及多种疾患并存,易于因含钾食物摄入不足,多种药物应用使排钾增多或细胞外钾向细胞内转移而发生低钾,低血钾为混合因素所致,需临床积极预防及控制。

Objective To explore the clinical features,causes and treatment of hypokalemia in older patients with diabetes.Methods A retrospective study was conducted to analyze 115 cases aged over 60 years with type 2 diabetes mellitus and hypokalemia.The correlated causes and clinical features were analyzed.Results Of the 115 cases of hypokalemia,103 cases（89.5%） were mainly with mild to moderate level of serum potassium.The decreased oral intake and medication induced hypokalemia were the most common causes in older diabetic patients.Spearman’s correlation analysis showed that the Hb A1c（r=-0.318,P〈0.05） and the number of coexisting co-morbid conditions（r=-0.406,P〈0.05） were negatively correlated with the level of serum potassium.Conclusion Hypokalemia is easily occurred in older diabetic patients due to decreased oral intake of potassium rich food and medication induced potassium loss and extra to intra cellular transfer,which was related to long-term glycemic management and coexisting co-morbid conditions.Hypokalemia is caused by mixed factors and needs clinical attention to be actively prevented and controlled.