Guan Yu, Wu Xuesi, Xu Min, Wu Jiahui
Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing 100029, China. Email:
Zhonghua Xin Xue Guan Bing Za Zhi. 2014 Jul;42(7):582-7.
To observe the level of blood sodium in patients hospitalized for heart failure with water-sodium retention treated with loop diuretics and risk factors of low blood sodium.
We selected 1 378 acute decompensated heart failure patients who visited Anzhen Hospital, and they are treated with loop diuretics, 259 patients with weight loses more than 1 kg in one week was enrolled in the final analysis, and divided into 3 groups: Group A (weight reduction between 1-3 kg), Group B (weight reduction between 3-5 kg) and Group C (weight reduction over 5 kg). Blood sodium, creatinine and uric acid were compared among groups and risk factors of low blood sodium were analyzed.
Blood sodium was similar before and post loop diuretics treatment in Group A, and reduced in group B ((138.28 ± 3.73) mmol/L vs. (139.34 ± 3.66) mmol/L, P < 0.05) and in Group C((137.60 ± 4.07) mmol/L vs. (139.44 ± 4.12) mmol/L, P < 0.05). Forty-six (17.8%) patients developed hyponatremia post loop diuretics treatment. Duration of loop diuretics use was the independent risk infector for hyponatremia (OR = 1.191, 95%CI 1.010-1.385).
Loop diuretics use is safe for treating hospitalized patients for heart failure with water-sodium retention and the risk of developing hyponatremia is low. Duration of loop diuretics use is the independent risk factor of hyponatremia.
观察襻利尿剂治疗水钠潴留性心力衰竭住院患者的血钠水平及低血钠的危险因素。
选取1378例就诊于安贞医院的急性失代偿性心力衰竭患者，均接受襻利尿剂治疗，最终纳入1周内体重下降超过1kg的259例患者进行分析，并分为3组：A组（体重下降1-3kg）、B组（体重下降3-5kg）和C组（体重下降超过5kg）。比较各组血钠、肌酐和尿酸水平，并分析低血钠的危险因素。
A组襻利尿剂治疗前后血钠水平相似，B组（（138.28±3.73）mmol/L对（139.34±3.66）mmol/L，P<0.05）和C组（（137.60±4.07）mmol/L对（139.44±4.12）mmol/L，P<0.05）血钠降低。46例（17.8%）患者襻利尿剂治疗后发生低钠血症。襻利尿剂使用时间是低钠血症的独立危险因素（OR=1.191，95%CI 1.010-1.385）。
襻利尿剂用于治疗水钠潴留性心力衰竭住院患者是安全的，发生低钠血症的风险较低。襻利尿剂使用时间是低钠血症的独立危险因素。
