大剂量呋塞米与螺内酯联合治疗老年重度心力衰竭的临床观察

目的探讨大剂量呋塞米与螺内酯联合治疗老年重度心力衰竭的临床效果。方法回顾性分析2016年2月～2018年12月我院收治的126例老年重度心力衰竭患者临床资料,依据呋塞米用药剂量不同分为A、B、C三组,A组以10mg/h速度滴注呋塞米联合螺内酯,B组以20mg/h速度滴注呋塞米联合螺内酯,C组以40mg/h速度滴注呋塞米联合螺内酯。对比3组患者治疗前后心功能变化,并观察3组患者临床症状改善情况与不良反应发生情况。结果治疗后,C组呼吸困难、下肢浮肿改善时间较A组与B组短,差异有统计学意义(P<0.05);C组患者左心室舒张末期内径(LEVDD)、左室收缩末期内径(LVESD)值比A、B组低,左室射血分数(LVEF)值比A、B组高,差异有统计学意义(P<0.05);3组不良反应发生率比较,差异无统计学意义(P>0.05)。结论大剂量呋塞米联合螺内酯治疗老年重度心力衰竭可有效缓解患者的临床症状,促进患者心功能恢复,且不良反应少。     

托拉塞米与呋塞米对急性心力衰竭患者尿量及电解质影响比较

目的比较托拉塞米与呋塞米对急性心力衰竭患者尿量及电解质的影响。方法将149例急性心力衰竭患者随机分为4组：托拉塞米组（n=32）,呋塞米组（n=41）,托拉塞米＋螺内酯组（n=30）,呋塞米＋螺内酯组（n=46）,用药24小时,统计出入量,测定用药前后血钾和血钠浓度,对比分析各组患者尿量及血钠和血钾变化。结果①托拉塞米组和呋塞米组24小时尿量差异无统计学意义,（3591．34±835．15）ml vs（3525．22±842．51）ml（P〉0．05）;②托拉塞米组与呋塞米组对血钠影响差异无统计学意义,（2．24±0．97）mmol／L VS（2．29±1．05）mmol／L（P〉0．05）,托拉塞米＋螺内酯组利钠作用最强（3．11±1．72）mmol／L,与托拉塞米组和呋塞米组比较差异均有统计学意义（P〈0．01）;③在排钾作用方面,托拉塞米＋螺内酯组最小（0．09±0．05）mmol／L,而呋塞米组最大（0．25±0．32）mmol／L（P〈O．01）,托拉塞米组排钾小于呋塞米组（0．12±0．06）mmol／L（P〈0．01）。结论托拉塞米与呋塞米利尿、排钠作用相近,而托拉塞米排钾作用明显弱于呋塞米,两者交替使用,有助于增加疗效,减少利尿剂抵抗的发生。     

大剂量呋塞米联合螺内酯治疗重度心力衰竭患者的临床研究

目的:探究重度心力衰竭应用大剂量呋塞米与螺内酯联合治疗的效果。方法:选取2015年2月～2018年2月我院收治的92例重度心力衰竭患者为研究对象,按照随机数字表法分为对照组与观察组,每组46例。对照组予以常规剂量呋塞米联合螺内酯治疗,观察组予以大剂量呋塞米联合螺内酯治疗,两组均治疗7 d,比较两组总有效率、症状改善时间、心功能指标、不良反应发生情况。结果:观察组总有效率明显高于对照组,P0.05;观察组呼吸困难缓解时间、水肿消退时间明显短于对照组,P0.05;治疗前,两组心功能指标比较,无显著性差异(P0.05);治疗后,两组LVEDd、LVESd指标均明显降低,观察组明显低于对照组,LVEF指标均明显升高,观察组明显高于对照组,P0.05;观察组不良反应发生率与对照组比较,无显著性差异(P0.05)。结论:大剂量呋塞米联合螺内酯治疗重度心力衰竭能促进患者症状缓解,改善患者心功能,疗效显著,安全可靠。     

心力衰竭患者如何合理使用利尿剂?

<正>1袢利尿剂临床上常用的袢利尿剂有呋塞米、托拉塞米、布美他尼,美国心脏病协会将其并列推荐治疗心力衰竭,三者利尿强度依次增强,10mg托拉塞米的利尿作用与20～40 mg呋塞米和1 mg布美他尼的利尿作用相当。1.1呋塞米呋塞米是治疗心力衰竭应用最多的药物,适用于有明显体液潴留或肾功能受损的患者。2008年欧洲心脏病学会建议呋塞米治疗慢性心力衰竭(CHF)的起始剂量为20～40 mg/d,常用剂量为40～240 mg/d。呋塞米在口服30min内、静脉注     

联合应用大剂量呋塞米、小剂量多巴胺及高渗盐水治疗顽固性心功能衰竭的疗效观察

目的探讨高渗盐水联合大剂量呋塞米、小剂量多巴胺持续静脉注射在顽固性心衰治疗中的实际应用价值。方法选择已经接受常规利尿、扩血管等治疗效果不显著的顽固性心衰患者32例,实施高渗盐水联合大剂量呋塞米、小剂量多巴胺持续静脉注射治疗方案,常规口服螺内酯,低钾血症患者静脉补钾。结果治疗后患者体质量明显减轻,血钠、钾、氯浓度明显升高,呼吸困难均较前减轻,水肿明显消退。结论联合应用大剂量呋塞米、小剂量多巴胺及高渗盐水治疗顽固性心衰疗效显著,值得,临床应用。     

利尿剂呋塞米联合多巴胺治疗难治性肝腹水的临床分析

目的研究难治性肝腹水患者应用多巴胺联合呋塞米治疗的临床效果。方法临床纳入112例我院2012年5月~2015年5月收治的难治性肝硬化腹水患者,所有患者按随机数字表法分为两组,其中56例患者采用多巴胺治疗作为对照组,另56例患者在上述基础上联合利尿剂呋塞米治疗作为观察组。结果对照组、观察组总有效率分别为83.93%、96.43%,观察组明显较高(P0.05)。治疗前两组患者血钾、血钠、24h尿钾以及24h尿钠水平均无差异,P0.05;治疗后,两组患者血钾、血钠水平依然无差异(P0.05),而观察组24h血钾、24h血钠水平明显高于对照组(P0.05)。对照组、观察组不良反应发生率分别为10.71%、7.14%,无显著差异(P0.05)。结论难治性肝硬化腹水采用呋塞米联合多巴胺治疗效果显著,不影响电解质水平,不良反应少,值得临床应用及推广。     

托伐普坦联合呋塞米治疗心力衰竭的临床效果分析

目的探讨托伐普坦联合呋塞米治疗慢性心力衰竭患者的临床效果。方法选取我院2017年6月～2018年1月收治的慢性心力衰竭患者70例,分为对照组和研究组各35例。对照组采用呋塞米治疗,研究组采用托伐普坦联合呋塞米治疗,比较两组治疗效果及不良反应发生情况。结果研究组治疗总有效为94.3%,显著高于对照组的80%,差异有统计学意义(P0.05);治疗后,观察组患者尿量、血钾、血钠及心脏射血分数(LVEF)等指标均优于对照组,差异有统计学意义(P0.05);研究组不良反应发生率为5.7%,显著低于对照组的20%,差异有统计学意义(P0.05)。结论托伐普坦联合呋塞米治疗慢性心力衰竭,可以有效改善患者的血钠、血钾水平,改善患者心脏功能,且临床安全性较高。     

托拉塞米对糖尿病肾病性水肿的疗效

目的观察托拉塞米及呋塞米对糖尿病肾病(diabetic nephropathy,DN)水肿的临床疗效。方法将60例DNⅣ期水肿患者随机分为呋塞米静脉注射组(对照组)、托拉塞米静脉注射组(托拉塞米A组)、托拉塞米持续泵入组(托拉塞米B组)。监测患者治疗前、治疗后第1天、第4天及第7天24小时尿量、血肌酐、血钾及血钠;治疗前及治疗后第7天脑钠肽(BNP)指标变化。结果治疗前,3组患者24小时尿量、血肌酐、血钾及血钠比较差异无统计学意义;治疗后,托拉塞米A组及B组24小时尿量均高于对照组,而托拉塞米B组较托拉塞米A组尿量增加(P0.01);3组患者血肌酐水平、血钾比较差异无统计学意义(P0.05);与治疗前比较,3组患者血钠均较前下降,但托拉塞米B组降钠作用强于其他两组;3组患者治疗后第7天BNP均明显下降(P0.01)。结论托拉塞米利尿作用强于呋塞米,托拉塞米采用持续静脉泵入具有更强的利尿作用。     

大剂量呋塞米联合高渗盐水治疗顽固性心力衰竭24例临床护理

目的：探讨大剂量呋塞米加高渗盐水治疗顽固性心力衰竭的临床疗效及护理方法。方法：将48例顽固性心力衰竭患者采用随机数字表法将其分为治疗组和对照组各24例,两组均采取心理护理、密切观察用药情况、严格卧床休息等综合护理措施,治疗组在此基础上静滴大剂量呋塞米加高渗盐水治疗;对照组静滴呋塞米,不加高渗盐水,分析比较两组的治疗效果。结果：治疗组显效11例,有效8例,无效5例（包括死亡2例）,总有效率79.17%;对照组显效5例,有效7例,无效12例（包括死亡4例）,总有效率50%,两组比较差异有统计学意义（χ2=4.46,P〈0.05）。结论：大剂量呋塞米合并高渗盐水能显著提高顽固性心力衰竭的治疗成功率,缜密的护理措施是提高治愈率的有力保障。     

大剂量呋塞米联合高渗盐水治疗顽固性心力衰竭24例临床护理

目的:探讨大剂量呋塞米加高渗盐水治疗顽固性心力衰竭的临床疗效及护理方法.方法:将48例顽固性心力衰竭患者采用随机数字表法将其分为治疗组和对照组各24例,两组均采取心理护理、密切观察用药情况、严格卧床休息等综合护理措施,治疗组在此基础上静滴大剂量呋塞米加高渗盐水治疗;对照组静滴呋塞米,不加高渗盐水,分析比较两组的治疗效果.结果: 治疗组显效11例,有效8例,无效5例(包括死亡2例),总有效率79.17%;对照组显效5例,有效7例,无效12例(包括死亡4例),总有效率50%,两组比较差异有统计学意义(χ2=4.46,P<0.05).结论:大剂量呋塞米合并高渗盐水能显著提高顽固性心力衰竭的治疗成功率,缜密的护理措施是提高治愈率的有力保障.     

Serum concentration of potassium in chronic heart failure patients administered spironolactone plus furosemide and either enalapril maleate, losartan potassium or candesartan cilexetil

OBJECTIVE: To retrospectively investigate elevation of serum potassium when spironolactone (25 or 50 mg/day) and furosemide were administered concomitantly with an angiotensin II converting enzyme inhibitor (ACE-I) or angiotensin II receptor blocker (ARB) to patients with chronic heart failure for 12 months and occurrence of hyperkalemia and hypokalemia because of concomitant administration of spironolactone plus an ACE-I or ARB and furosemide. METHODS: Patients with chronic heart failure, who visited departments of cardiovascular internal medicine and cardiovascular surgery at the National Hospital Organization Osaka Medical Center, were enrolled for this study. Serum potassium, blood urea nitrogen (BUN), serum creatinine, uric acid, and serum sodium were determined in every patient at the time of start of treatment and at 3 and 12 months of treatment. Data from patients in Groups A (25 mg/day spironolactone + 40 mg/day furosemide + an ACE-I or ARB) and B (50 mg/day spironolactone + 40 mg/day furosemide + an ACE-I or ARB) were analysed for differences with respect to the ACE-I and ARB used. RESULTS: When 50 mg/day spironolactone plus 5 mg/day enalapril maleate (enalapril) or 50 mg/day losartan potassium (losartan) or 8 mg/day candesartan cilexetil (candesartan) plus 40 mg/day furosemide were concomitantly used, the mean value of serum potassium was significantly elevated only in the group treated with 50 mg/day spironolactone regardless of the concomitant drug. The number of patients with hyperkalemia (>5.5 mEq/L) at 12 months of treatment was 12 (8.8%), while the number of patients with hypokalemia (相似文献   

Carvedilol accelerate elevation of serum potassium in chronic heart failure patients administered spironolactone plus furosemide and either enalapril maleate or candesartan cilexetil

OBJECTIVE: To retrospectively investigate the effect of carvedilol and spironolactone plus furosemide, administered concomitantly with an angiotensin II converting enzyme inhibitor (ACE-I) or an angiotensin II receptor blocker (ARB) to patients with chronic heart failure (CHF). METHODS: Patients with CHF, who visited Departments of Cardiovascular Internal Medicine at the National Hospital Organization Osaka Medical Center, were enrolled for this study. Serum potassium, blood urea nitrogen (BUN), serum creatinine (Scr) and serum sodium were measured in every patient at the time of start of treatment and after 3 and 12 months of treatment. Data from patients in groups A (20 mg/day carvedilol + 25 mg/day spironolactone + 40 mg/day furosemide + an ACE-I) and B (20 mg/day carvedilol + 25 mg/day spironolactone + 40 mg/day furosemide + ARB) were compared. RESULTS: When 20 mg/day carvedilol plus 25 mg/day spironolactone plus 5 mg/day enalapril maleate (enalapril, group A) or 8 mg/day candesartan cilexetil (candesartan, group B) plus 40 mg/day furosemide were used concomitantly, the mean serum potassium increased significantly in both groups of patients. Seven of 59 (11.9%) patients had hyperkalemia (>5.5 mEq/L) during 12 months of treatment whereas 8.5% of patients (five of 59) had hypokalemia (< or =3.5 mEq/L). CONCLUSION: When carvedilol is used concomitantly with spironolactone, furosemide and enalapril or candesartan, it is necessary to monitor serum potassium concentration, even if spironolactone is administered at a low dose of 25 mg/day.     

重症急性胰腺炎早期血钾变化的临床分析

目的：探讨重症急性胰腺炎（SAP）患者早期血钾变化的发生机制和临床特点,对预后的影响及治疗措施。方法2002年9月1日至2012年5月31日收治的SAP 331例,分成轻度低钾血症组（血钾2.5～3.5 mmol/L）74例和重度低钾血症组（＜2.5 mmol/L）5例,血钾正常组（3.5～5.5 mmol/L）233例,高钾血症组（＞5.5 mmol/L）19例。分析比较各组SAP患者的相关并发症、相关临床参数、病死率和感染率。结果在 SAP 病程早期重度低钾血症组急性呼吸窘迫综合征（ARDS）发生率与血钾正常组相比无明显差异（P＞0.05）。重度低钾血症组胰性脑病的发生率与其他三组相比差异显著（P＜0.01）。高钾血症组肾功能衰竭、ARDS、心力衰竭及消化道出血的发生率明显高于轻度低钾血症组（P＜0.01）。高钾血症组的脉搏、呼吸、LDH、血糖、甘油三酯、血钙、HCT、Ranson 评分、APACHEⅡ评分、CT 评分均明显异于其他三组患者（P＜0.01）。高钾血症组与其他三组比较死亡率明显增高（P＜0.01）,轻度低钾血症组与重度低钾血症组比较差异明显（P＜0.05）,血钾正常组与轻度低钾血症组的死亡率相比较差异无明显统计学意义（P＞0.05）。说明患者如出现高钾血症死亡风险明显高于其他血钾异常组,血钾太低死亡风险亦增加。重度低钾血症组患者感染率与其他三组患者相比差异有明显统计学意义（P＜0.05）。结论高钾血症组出现肾脏、肺、心、消化道器官衰竭的概率高,而重度低钾血症组胰性脑病的发生率高。高钾血症组的SAP患者病情严重度高,死亡率高,但感染率不高于其他组患者。血钾降低死亡风险亦增加。     

基于DOPPS研究分析中国血液透析患者高钾血症的患病率及相关影响因素

目的高钾血症是终末期肾病患者的常见合并症之一,严重高钾血症可引起致死性心律失常而危及生命。本研究旨在探究中国透析预后与实践模式研究(Dialysis Outcomes and Practice Patterns Study,DOPPS)中血液透析(hemodialysis,HD)患者合并高钾血症的情况,并探究血液透析患者合并高钾血症的独立相关因素。方法DOPPS是1项国际性的前瞻性观察研究,中国参加了DOPPS5(2012~2015),并完成了队列的随访。中国DOPPS5中纳入了1427名患者。以这些患者为研究对象,收集实验检查中透析前血钾的值,分为正常血钾组(血钾<5.5mmol/L)和高钾血症组(血钾≥5.5mmol/L)。根据严重程度进一步将高钾血症分为轻度(5.5~5.9mmol/L)、中度(6.0~6.4mmol/L)或重度(≥6.5 mmol/L)。比较2组间的一般资料、实验室检查及透析处方间的差异,并用多因素Logistic回归分析探究高钾血症的独立相关因素。结果本研究共纳入了1339名HD患者,平均年龄为(59.4±14.9)岁,中位透析龄为2.6(0.9,5.3)年,男性占54.4%。合并高钾血症的患者为345人(25.8%),其中轻度高钾血症占13.3%,中度高钾血症占7.6%,重度高钾血症占4.9%。3个城市中,北京的HD患者合并高钾血症的比例最高(31.8%),其次是广州(26.0%),上海的患者中合并高钾血症的比例最低(19.3%)(χ²=18.580,P<0.001)。血钾正常和高钾血症的2组患者在年龄(t=2.610,P=0.009)、性别比例(χ²=4.059,P=0.007)、BMI(t=-2.680,P=0.008)、透析充分性(t=4.280,P<0.001)、透析频次(χ²=21.548,P<0.001)、血白蛋白(t=6.071,P<0.001)、血磷(t=7.083,P<0.001)等方面均有显著差异。多因素Logistic回归分析示,较高的BMI(OR:1.040,95%CI:1.004~1.077,P=0.027)、女性(OR:1.201,95%CI:1.023~2.547,P=0.026)、透析液钾浓度≥2.5mEq/L(相比于<2.5mEq/L)(OR:1.194,95%CI:1.028~1.386,P=0.020)、透析充分性不达标(stdKt/V<2)(OR:1.336,95%CI:1.170~1.527,P<0.001)、透析频次低于每周3次(OR:1.332,95%CI:1.150~1.544,P<0.001)、血白蛋白水平高(OR:1.815,95%CI:1.294~2.547,P<0.001)、血磷水平高(OR:1.231,95%CI:1.153~1.316,P<0.001)是与HD患者合并高钾血症的独立相关因素。结论在中国DOPPS5研究中,25.8%的HD患者合并高钾血症。纳入的3个城市中,北京患者中合并高钾血症的比例最高,其次是广州,上海最低。较高的BMI、女性、透析液钾浓度≥2.5mEq/L(相比于<2.5mEq/L)、透析充分性不达标(stdKt/V<2)、透析频次低于每周3次、血白蛋白水平高、血磷水平高是HD患者合并高钾血症的独立相关因素。     

急性心肌梗死早期低血钾与心衰的关系

目的 探讨急性心肌梗死（AMI）患者早期低钾血症的变化以及与心力衰竭的关系。方法收集200例急性心肌梗死的患者,发病时间小于24小时,所有患者均为首次入院。根据血钾浓度分为低钾血症组和正常血钾组,其中低钾血症组又分为重度低钾组（〈2．50mmol／L）、中度低钾组（2．51mmol／L-3．0mmool／L）和轻度低钾组（3．01-3．50mmol／L）。所有患者予以常规积极治疗,观察心力衰竭发生情况。结果AMI患者低钾血症的发生率为73．5％,低钾血症组心力衰竭的发生率为51．7％,明显高于正常组（22．6％）,其中重度低钾组心衰的发生率78．2％,中度低钾组为58．3％,轻度低钾组为38．9％。结论急性心肌梗死早期易出现低钾血症,并且随着血钾浓度的降低,心力衰竭的发生率也明显增高。     

危重患者高浓度静脉补钾的安全性和疗效研究

目的 探讨高浓度钾微量泵入治疗危重患者低钾血症的安全性及有效性.方法 128例合并低钾血症的危重患者[内生肌酐清除率(CCr)＞0.5 ml/s且每小时尿量＞50 ml]被随机分为治疗组和对照组,各64例.治疗组和对照组补钾浓度分别为1 208 mmol/L(相当于质量分数为9%的KCl溶液)、201 mmol/L(相当于1.5%的KCI溶液),补钾速度相同.均进行严密监测与血钾浓度监测,血钾正常时停止补钾.结果 治疗组和对照组补钾时间比较差异无统计学意义[(15.55±3.22)h比(14.18±4.93)h,P＞0.05];治疗组补钾的液体量明显低于对照组[(124.36±25.79)ml比(680.83±36.70)ml,P＜0.01].两组治疗过程中均未发生明显血流动力学变化、高钾血症或急性心功能不全.两组患者肾功能是否正常对补钾时间无明显影响.补钾前血钾浓度与补钾量有一定相关性(相关系数r=-0.259,P＜0.01).结论 高浓度钾微量泵入治疗危重患者低钾血症可以在短时间内纠正低钾血症,是安全有效的.肾功能轻度异常但无少尿及无尿的患者也可以在严密监测下高浓度补钾.     

Beating the odds--surviving extreme hyperkalemia

Severe hyperkalemia (>7 mmol/L) is a medical emergency because of possible fatal arrhythmias. We here report the case of a 58-year-old woman surviving extreme hyperkalemia (>10 mmol/L). The patient with a history of congestive heart failure, a DDD pacemaker and mild chronic renal insufficiency was admitted with progressive weakness and sudden onset of hypotension and bradycardia in the absence of any pacemaker action. Laboratory tests revealed an extreme serum potassium level of 10.1 mmol/L, with a slightly elevated serum creatinine of 149 μmol/L. Treatment with norepinephrine, sodium bicarbonate, and insulin improved both the hemodynamic situation and the serum potassium with subsequent regaining pacemaker actions even before additional hemodialysis normalized the potassium level. A thorough investigation demonstrated that several mechanisms contributed to the extreme potassium level: urinalysis and a low transtubular potassium gradient in the presence of metabolic acidosis with normal anion gap pointed to preexisting interstitial nephritis, with renal tubular acidosis type IV as the predisposing factor, whereas several drugs and acute impairment of renal function contributed to the dangerous situation. Despite the odds for fatal outcome, the patient recovered completely, and long-term management was initiated to prevent recurrent hyperkalemia.     

Diuretic therapy in congestive heart failure--new views on spironolactone therapy

Cardiac pump failure leads to a reduction of the effective arterial volume. This is sensed by the kidney via afferent sympathetic fibres. The renal response to the perceived lack of volume is the retention of sodium and water. Although initially homeostatic, this renal counterregulation is maladaptive later on and may contribute to further cardiac compromise by increasing preload (volume retention) and afterload (hyperreninism). The renal sodium retention in congestive heart failure is a consequence of the activation of the sympathetic nervous system and of the renin-angiotensin-aldosterone system. The retention of osmotically free water is partly caused by the nonosmotic secretion of antidiuretic hormone from the posterior pituitary and partly by a diminished osmoregulatory capacity of the kidney due to diuretic therapy and/or (pre-)renal insufficiency. In the near future specific blocking drugs of vasopressin receptors should become available which could make a significant contribution to the management of hyponatremia in this setting. For the management of extracellular volume overload a negative sodium balance is the central objective. A moderate reduction of sodium intake is helpful to achieve this goal and has the additional benefit of reducing thirst and renal potassium loss. However, the majority of patients require (loop) diuretics in addition. Patients who are refractory to high and repeated doses of loop diuretics may respond to a combination of diuretics which act on different nephron segments. Diuretics increase the risk of hypokalemia which can trigger life-threatening tachyarrhythmia, particularly in patients with cardiac dysfunction. Hypokalemia is therefore an indicator of an adverse outcome. Secondary hyperaldosteronism--which can persist despite effective therapy with ACE-inhibitors--is the major cause of hypokalemia in this setting. The randomized aldactone evaluation study (RALES) has shown that spironolactone (25 mg/day) reduced the risk of hypokalemia and decreased morbidity, mortality and clinical symptoms in patients with heart failure. The recent encouraging results with vasopressin receptor antagonists and spironolactone point to the fact that the therapeutic modification of maladaptive homeostatic renal mechanisms plays an increasingly important role in the modern diuretic management of heart failure beyond symptomatic relief from volume overload.     

雾化吸入氯化钾在纠正慢性阻塞性肺疾病病人轻度低钾血症中的应用

[目的]探讨雾化吸入氯化钾在纠正慢性阻塞性肺疾病(COPD)病人轻度低钾血症中的应用。[方法]将90例COPD合并轻度低钾血症病人随机分为A组、B组、C组,每组30例,根据血清钾浓度,A组采用口服补钾,B组采用静脉补钾,C组采用雾化吸入补钾。比较3组病人补钾前后血清钾变化情况及副反应发生情况。[结果]3组病人补钾的效果比较,差异无统计学意义(P>0.05);A组病人胃肠道不适症状发生率高于C组与B组,B组静脉刺激症状发生率高于C组与A组,而C组发生咳嗽,与A组、B组比较,差异无统计学意义。[结论]雾化吸入补钾可改善COPD病人轻度低钾血症且副反应少。