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限钠与噻嗪类利尿剂治疗高血压

Sodium restriction and thiazide diuretics in the treatment of hypertension.

作者信息

Carney S, Morgan T, Wilson M, Matthews G, Roberts R

出版信息

Med J Aust. 1975 Jun 28;1(26):803-7. doi: 10.5694/j.1326-5377.1975.tb82051.x.

Abstract

In a group of hypertensive patients it has been shown that moderate sodium chloride restriction has a hypotensive effect that is similar to that produced by thiazide diuretics. Blood pressure changed in relation to body weight in individual patients, and appeared to correlate with their sodium balance. The more a patient was depleted of sodium, the lower was the blood pressure. The serum potassium level fell with the use of thiazide diuretics, but in this group of patients there was little change in total body potassium content. The fall in serum potassium level appeared to relate to a shift into the cells due to the accompanying alkalosis. Potassium supplementation appeared to have had little effect and was unnecessary for most patients who were given diuretics for hypertension. Amiloride corrected the alkalosis and restored the serum potassium level to normal.

摘要

在一组高血压患者中,已表明适度限制氯化钠摄入具有与噻嗪类利尿剂产生的降压效果相似的降压作用。个体患者的血压随体重变化,且似乎与其钠平衡相关。患者钠缺失越多,血压越低。使用噻嗪类利尿剂时血清钾水平下降,但在这组患者中总体钾含量变化不大。血清钾水平下降似乎与伴随碱中毒导致的钾向细胞内转移有关。补钾似乎效果不佳,对于大多数因高血压服用利尿剂的患者而言并无必要。氨氯吡咪纠正了碱中毒并使血清钾水平恢复正常。

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