Dyckner T, Wester P O
Am J Med. 1987 Mar 20;82(3A):11-7. doi: 10.1016/0002-9343(87)90127-6.
Diuretic-induced deficiencies in potassium and magnesium can have significant implications for patients with cardiovascular disease. Hypokalemia, found in up to 50 percent of patients receiving thiazide therapy, is associated with a greater frequency of serious arrhythmias and increased mortality in patients with acute myocardial infarction. Hypomagnesemia has been identified in 42 percent of patients with hypokalemia, and below normal muscle magnesium levels have been found in 43 percent of congestive heart failure patients receiving diuretics. Magnesium is important for maintenance of cell potassium, and infusions of magnesium alone have increased muscle potassium and magnesium levels and significantly decreased the frequency of ventricular ectopic beats. It has been shown that both potassium and magnesium are conserved by potassium-sparing agents. Because serum and tissue magnesium levels are not correlated and correlations for potassium levels are weak, prevention of these electrolyte abnormalities is advised.
利尿剂引起的钾和镁缺乏对心血管疾病患者可能有重大影响。接受噻嗪类治疗的患者中，高达50%会出现低钾血症，这与严重心律失常的发生率增加以及急性心肌梗死患者死亡率升高有关。低钾血症患者中有42%被发现存在低镁血症，在接受利尿剂治疗的充血性心力衰竭患者中，43%的患者肌肉镁水平低于正常。镁对于维持细胞内钾很重要，单独输注镁可提高肌肉钾和镁水平，并显著降低室性早搏的发生率。已表明保钾药物可保留钾和镁。由于血清和组织镁水平不相关，钾水平的相关性较弱，因此建议预防这些电解质异常。
