Laso F J, González-Buitrago J M, Martin-Ruiz C, Vicens E, Moyano J C
Departamento de Medicina (Patologia General), Hospital Clinico Universitario, Salamanca, Spain.
Drug Alcohol Depend. 1990 Oct;26(2):183-8. doi: 10.1016/0376-8716(90)90126-y.
Serial analyses of serum potassium and plasma epinephrine, norepinephrine and adenosine 3':5'-cyclic monophosphate (cyclic AMP) concentrations were measured in 13 patients with alcohol withdrawal, six of whom presented delirium tremens. Patients with delirium showed at admission levels of potassium (3.45 +/- 0.45 mmol/l) lower (P less than 0.02) than patients without delirium (3.81 +/- 0.14 mmol/l). Three patients were hypokalemic, all of them with delirium. Serum potassium increased significantly in all the patients during evolution. A close negative correlation (r = -0.751) between the intensity of withdrawal and serum potassium was observed. Plasma epinephrine concentrations were increased at admission (623 +/- 192 pmol/l), patients with delirium showing greater values (705 +/- 137 pmol/l). As the alcohol withdrawal improved, plasma epinephrine concentration decreased. Plasma norepinephrine concentrations were also increased at admission (3422 +/- 1451 pmol/l), but did not change significantly during evolution, being similar in patients with and without delirium. Plasma cyclic AMP levels were high at admission (40.4 +/- 24.3 nmol/l) and increased significantly (P less than 0.05) during evolution. The data obtained suggest that in patients with alcohol withdrawal, as symptomatology improves, plasma epinephrine decreases, while plasma norepinephrine remains increased. The combined actions of the two facts--less beta-stimulus, maintaining of alpha-stimulus--would comprise a significant increase of kalemia, that in cases of initial hypokalemia would lead to normal values of serum potassium.
对13例酒精戒断患者进行了血清钾、血浆肾上腺素、去甲肾上腺素和3':5'-环磷酸腺苷（环磷酸腺苷）浓度的系列分析，其中6例出现震颤谵妄。出现震颤谵妄的患者入院时的血钾水平（3.45±0.45 mmol/L）低于未出现震颤谵妄的患者（3.81±0.14 mmol/L）（P<0.02）。3例患者存在低钾血症，均伴有震颤谵妄。在病情发展过程中，所有患者的血清钾均显著升高。观察到戒断强度与血清钾之间存在密切的负相关（r = -0.751）。入院时血浆肾上腺素浓度升高（623±192 pmol/L），出现震颤谵妄的患者数值更高（705±137 pmol/L）。随着酒精戒断情况改善，血浆肾上腺素浓度降低。入院时血浆去甲肾上腺素浓度也升高（3422±1451 pmol/L），但在病情发展过程中无显著变化，出现和未出现震颤谵妄的患者相似。入院时血浆环磷酸腺苷水平较高（40.4±24.3 nmol/L），在病情发展过程中显著升高（P<0.05）。获得的数据表明，在酒精戒断患者中，随着症状改善，血浆肾上腺素降低，而血浆去甲肾上腺素仍升高。这两个因素的联合作用——较少的β刺激，α刺激的维持——将导致血钾显著升高，在初始低钾血症的情况下会使血清钾达到正常水平。
