Carlmark B, Kromhout D, Reizenstein P
Scand J Clin Lab Invest. 1975 Nov;35(7):617-23.
Three groups of patients with suspected potassium depletion were studied. Twenty-nine obese patients were observed before and up to 1 year after an intestinal shunt operation. During the first week after operation they lost almost 3 grams of potassium per day. The percentage potassium loss was much larger than the percentage weight loss. A significant decrease of serum potassium was also noted during the first week after operation. In contrast to the total body potassium, however, the serum potassium remained within normal limits in all patients except two. Fourteen patients subjected to a cardiac operation also showed a significant decrease of total body potassium concentration 1 week after operation. The serum potassium remained within normal limits. In 187 patients with suspected potassium depletion the total body potassium had been measured, and the results were examined retrospectively. In 38 of these patients the measured total body potassium was outside a 94% confidence interval for an individually predicted value, even though 26 of these 38 patients were taking oral potassium chloride tablets. In 23 of these 38 patients two or three risk factors - hypoalbumin-emia, treatment with diuretics, and treatment with digitalis - were present simultaneously, and in 10 patients one factor was present. Only 8 of the 38 patients had a low serum potassium value. It may therefore be concluded that the total body potassium measurement, when compared with an individually predicted value, seems to be more sensitive in estimation of potassium depletion than the commonly used serum potassium method.
对三组疑似低钾血症患者进行了研究。观察了29例肥胖患者在肠道分流手术前及术后长达1年的情况。术后第一周,他们每天几乎流失3克钾。钾流失的百分比远大于体重减轻的百分比。术后第一周还观察到血清钾显著下降。然而,与全身钾含量不同的是,除两名患者外,所有患者的血清钾均保持在正常范围内。14例接受心脏手术的患者术后1周全身钾浓度也显著下降。血清钾保持在正常范围内。对187例疑似低钾血症患者测量了全身钾含量,并对结果进行了回顾性分析。在这些患者中,有38例测量的全身钾含量超出了个体预测值的94%置信区间,尽管这38例患者中有26例正在服用氯化钾片剂。在这38例患者中,有23例同时存在两到三个危险因素——低白蛋白血症、利尿剂治疗和洋地黄治疗,10例患者存在一个危险因素。38例患者中只有8例血清钾值较低。因此可以得出结论,与个体预测值相比,全身钾测量在评估钾缺乏方面似乎比常用的血清钾方法更敏感。