Sawyer N, Gabriel R
St Mary's Hospital, London, UK.
Postgrad Med J. 1988 Jun;64(752):434-7. doi: 10.1136/pgmj.64.752.434.
Three different thiazide potassium-sparing diuretic combinations were given to elderly patients for heart failure. Eighty patients received their allocated combinations for 3 years and had 6-monthly measurements of plasma potassium. A further 84 were recruited for study but 29 died within 6 months and 55 had to be withdrawn from the trial. The triamterene-containing preparation was discontinued most frequently (6/44) because of hypokalaemia (plasma potassium less than 3.0 mmol/l); amiloride (5/44) and spironolactone (1/47). The median fall in plasma potassium over 3 years in those patients not withdrawn because of hypokalaemia was similar in each case (P greater than 0.05) and possibly failed to reach significance because of the withdrawal rate (9%). The trend was for a greater fall in those patients taking triamterene. The spironolactone-containing preparation may be the least unsatisfactory of the three.
将三种不同的噻嗪类保钾利尿剂组合给予老年心力衰竭患者。80名患者接受分配的组合治疗3年，并每6个月测量一次血钾。另外招募了84名患者进行研究，但29人在6个月内死亡，55人不得不退出试验。含氨苯蝶啶的制剂因低钾血症（血钾低于3.0 mmol/L）而停药最为频繁（6/44）；阿米洛利（5/44）和螺内酯（1/47）。在未因低钾血症而退出的患者中，3年内血钾下降的中位数在每种情况下相似（P>0.05），可能由于退出率（9%）而未能达到显著差异。趋势是服用氨苯蝶啶的患者血钾下降幅度更大。含螺内酯的制剂可能是三种中最不令人不满意的。
