McDonald C J, Hui S L, Tierney W M
J Chronic Dis. 1986;39(2):127-35. doi: 10.1016/0021-9681(86)90069-x.
In order to determine which of the many diuretic-induced laboratory changes might be associated with an increased risk of ventricular ectopy (VE), we performed logistic regression analyses of patient data from a large computerized medical record system. Study variables included serum Ca2+, K+, Cl-, HCO-3, glucose, cholesterol, albumin, uric acid, and hematocrit. Controlling variables included race, use of diuretics, blood pressure, smoking history, age, and weight. (In one analysis we also included cardiac drug history and evidence of pre-existing cardiovascular disease). Separate analyses were performed for males and females. For the retrospective cohort-like design, we analyzed data for 9561 patients with complete data. For the case-control design we analyzed data from 4786 patients. Diuretic usage predicted ventricular ectopy in women, but not men. Serum uric acid and hematocrit were the only significant laboratory predictors of ventricular ectopy in each of the four analyses. Abnormalities in these variables might provide an explanation for the greater incidence in sudden (and presumably arrhythmic) deaths reported in MRFIT study patients with mild hypertension.
为了确定众多利尿剂引起的实验室检查变化中哪些可能与室性早搏（VE）风险增加相关，我们对来自大型计算机化医疗记录系统的患者数据进行了逻辑回归分析。研究变量包括血清Ca2+、K+、Cl-、HCO-3、葡萄糖、胆固醇、白蛋白、尿酸和血细胞比容。控制变量包括种族、利尿剂使用情况、血压、吸烟史、年龄和体重。（在一项分析中，我们还纳入了心脏用药史和既往心血管疾病证据）。对男性和女性分别进行分析。对于类似回顾性队列的设计，我们分析了9561例有完整数据患者的数据。对于病例对照设计，我们分析了4786例患者的数据。利尿剂使用可预测女性的室性早搏，但不能预测男性。在四项分析中的每一项中，血清尿酸和血细胞比容是室性早搏仅有的显著实验室预测指标。这些变量的异常可能为多重危险因素干预试验（MRFIT）研究中轻度高血压患者报告的突然（可能是心律失常性）死亡发生率较高提供一种解释。
