Paice B, Gray J M, McBride D, Donnelly T, Lawson D H
Br Med J (Clin Res Ed). 1983 Apr 9;286(6372):1189-92. doi: 10.1136/bmj.286.6372.1189.
Significant hyperkalaemia occurred in 406 out of 29 063 patients admitted to a major Scottish teaching hospital in one year (1.4%). Mortality was higher in these patients than in control patients and was strongly correlated with the severity of the hyperkalaemia. Overall seven deaths were directly due to hyperkalaemia (out of 58 deaths among patients with hyperkalaemia). Factors contributing to a poor prognosis were severity and speed of onset of hyperkalaemia and the presence of appreciable renal impairment. Patients with hyperkalaemia were older and more likely to be male; this trend was present in all diagnostic subcategories. Genitourinary disease, gastrointestinal disease, and cancer were significantly more common among the patients with hyperkalaemia than the controls. Hyperkalaemia due to drug treatment was invariably mild and non-fatal, whereas genitourinary disease was often associated with moderate to severe hyperkalaemia, which in two cases proved fatal. Use of electrocardiographic monitoring was rare, and although the treatment of hyperkalaemia was effective, it was often used when not required. Hyperkalaemia is a potential hazard in diabetic ketoacidosis, and use of potassium supplements should be carefully monitored during correction of the acidosis.
在一年时间里，苏格兰一家大型教学医院收治的29063名患者中有406人出现了严重高钾血症（1.4%）。这些患者的死亡率高于对照组患者，且与高钾血症的严重程度密切相关。总体而言，有7例死亡直接归因于高钾血症（在高钾血症患者的58例死亡中）。导致预后不良的因素包括高钾血症的严重程度和发作速度以及明显的肾功能损害。高钾血症患者年龄较大，男性居多；所有诊断亚类中均存在这一趋势。与对照组相比，高钾血症患者中泌尿生殖系统疾病、胃肠道疾病和癌症更为常见。药物治疗引起的高钾血症通常较轻且无致命性，而泌尿生殖系统疾病常与中度至重度高钾血症相关，其中有两例证明是致命的。很少使用心电图监测，尽管高钾血症的治疗有效，但常在不需要时使用。高钾血症在糖尿病酮症酸中毒中是一种潜在危害，在纠正酸中毒期间应仔细监测钾补充剂的使用情况。
