Papademetriou V, Price M, Johnson E, Smith M, Freis E D
Am J Cardiol. 1984 Nov 1;54(8):1015-9. doi: 10.1016/s0002-9149(84)80136-8.
Two groups of patients with uncomplicated systemic hypertension were studied. Group 1 included 11 patients who had overt hypokalemia with diuretic drug treatment, and group 2 included 11 patients who remained normokalemic. After baseline studies without treatment were performed, both groups received hydrochlorothiazide, 50 mg twice daily. Plasma potassium (PK) was significantly reduced within the first day of treatment and stabilized by day 7 in both groups. The average decrease in PK was 1.0 +/- 0.1 mEq/liter (p less than 0.01) in the first group and 0.6 +/- 0.2 mEq/liter (p less than 0.01) in the second group. Cumulative losses of K were approximately 200 mEq in the hypokalemic group and were minimal in the normokalemic group as assessed by 24-hour urinary collections. Patients in the hypokalemic group also had a greater reduction in body weight and blood pressure. Supplementation with KCl, 96 mEq/day, or triamterene, 200 mg/day, in 9 hypokalemic patients resulted in an increase of PK to approximately 3.5 mEq/liter leveling off by day 7, and a cumulative K retention of approximately 200 mEq. Thus, overt thiazide-induced hypokalemia was associated with small and biologically unimportant losses of K from body stores. With replacement therapy the estimated amount of retained K was also small.
对两组无并发症的系统性高血压患者进行了研究。第一组包括11例因利尿剂治疗出现明显低钾血症的患者，第二组包括11例血钾正常的患者。在进行未治疗的基线研究后，两组均接受氢氯噻嗪治疗，每日两次，每次50毫克。两组患者在治疗的第一天血浆钾（PK）均显著降低，并在第7天稳定下来。第一组PK的平均下降幅度为1.0±0.1毫当量/升（p<0.01），第二组为0.6±0.2毫当量/升（p<0.01）。通过24小时尿液收集评估，低钾血症组的钾累积损失约为200毫当量，而血钾正常组的损失最小。低钾血症组患者的体重和血压下降也更大。9例低钾血症患者补充氯化钾，每日96毫当量，或氨苯蝶啶，每日200毫克，导致PK在第7天增加至约3.5毫当量/升并趋于稳定，钾的累积潴留约为200毫当量。因此，明显的噻嗪类药物引起的低钾血症与体内钾储存的少量且生物学上无重要意义的损失有关。采用替代疗法时，估计潴留的钾量也很少。
