Dørup I, Skajaa K
Ugeskr Laeger. 1989 Mar 20;151(12):759-63.
Thiazides and loop diuretics, facilitate the loss of Mg and K resulting in increased excretion in the urine. Although serum-K and serum-Mg values in patients receiving long-term treatment for hypertension or incompensated heart disease usually are normal, muscle-Mg and muscle-K contents are reduced in around 50% of these patients. Mg deficiency increases K loss and K/Mg deficiencies are frequently observed simultaneously. K repletion is often difficult if the accompanying Mg deficiency is not corrected simultaneously. The K/Mg loss from the muscles is accompanied by reduced concentration of Na,K-pumps. These disturbances may produce muscle symptoms, increased sensitivity to digitalis, inhibition of growth and possibly arrhythmias. Evaluation of the K and Mg status during diuretic treatment should be preferentially based on tissue determinations. The muscle biopsy method is rapid, reliable and may reveal conditions of deficiency. In several cases, oral supplements of Mg have proved to be adequate to restore the normal K/Mg status.
噻嗪类利尿剂和袢利尿剂会促使镁和钾流失，导致尿液排泄增加。尽管接受高血压或失代偿性心脏病长期治疗的患者血清钾和血清镁值通常正常，但这些患者中约50%的肌肉镁和肌肉钾含量会降低。镁缺乏会增加钾流失，钾和镁缺乏常常同时出现。如果不同时纠正伴随的镁缺乏，补钾往往很困难。肌肉中钾和镁的流失伴随着钠钾泵浓度降低。这些紊乱可能会产生肌肉症状、对洋地黄的敏感性增加、生长抑制以及可能的心律失常。利尿剂治疗期间对钾和镁状态的评估应优先基于组织测定。肌肉活检方法快速、可靠，可能会揭示缺乏状况。在一些病例中，口服补充镁已被证明足以恢复正常的钾镁状态。
