Thanachartwet Vipa, Krudsood Srivicha, Tangpukdee Noppadon, Phumratanaprapin Weerapong, Silachamroon Udomsak, Leowattana Wattana, Wilairatana Polrat, Brittenham Gary M, Looareesuwan Sornchai, Neild Guy H
Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Ratchathevee, Bangkok, Thailand.
Trop Doct. 2008 Jul;38(3):155-7. doi: 10.1258/td.2007.070112.
In a retrospective study of 1415 patients aged 15 and over, we determined the incidence of clinically important hyponatraemia and hypokalaemia in adults with uncomplicated malaria. On admission, serum concentrations of sodium (135-145 mmol/L) and potassium (3.5-5.0 mmol/L) were found outside these reference ranges in 81% of patients. Severe hypokalaemia (K+ <3.0 mmol/L) and severe hyponatraemia (Na+ <125 mmol/L occurred in 4.4% and 0.6% of the patients, respectively. For hypokalaemia (43%) and hyponatraemia (37%), hypovolaemia, blood urea to creatinine ratio and high serum glucose (>100 mg/dL) were all independent factors (P < 0.001). Other independent predictors for hypokalaemia were Plasmodium vivax infection, female gender; and for hyponatraemia, P. falciparum infection, male gender, concentrations of G-6-PD and serum bicarbonate.
在一项针对1415名15岁及以上患者的回顾性研究中，我们确定了无并发症疟疾成年患者中具有临床意义的低钠血症和低钾血症的发生率。入院时，81%的患者血清钠浓度（135 - 145 mmol/L）和钾浓度（3.5 - 5.0 mmol/L）超出这些参考范围。严重低钾血症（K+ <3.0 mmol/L）和严重低钠血症（Na+ <125 mmol/L）分别发生在4.4%和0.6%的患者中。对于低钾血症（43%）和低钠血症（37%），低血容量、血尿素与肌酐比值以及高血糖（>100 mg/dL）均为独立因素（P < 0.001）。低钾血症的其他独立预测因素为间日疟原虫感染、女性性别；而低钠血症的独立预测因素为恶性疟原虫感染、男性性别、葡萄糖 - 6 - 磷酸脱氢酶浓度和血清碳酸氢盐。
