慢性充血性心力衰竭低盐饮食与低钠血症

目的探讨慢性充血性心力衰竭（CHF）患者合并低钠血症的病因、后果及治疗措施。方法120例慢性CHF患者，心功能NYHA分级Ⅲ-Ⅳ级，按就诊先后随机分为观察组60例和对照组60例。观察组给予常规抗心力衰竭治疗和低盐饮食，对照组给予常规抗心力衰竭治疗和正常饮食，观察期3个月。结果观察组中有32例发生轻度低钠血症，8例出现严重低钠血症，2例因严重低钠血症合并碱中毒和严重低钠血症致心功能恶化死亡；对照组中有2例发生轻度低钠血症，没有发生严重低钠血症及死亡。结论对于心功能Ⅲ-Ⅳ级慢性CHF患者需长期或间断服用利尿剂，适当补充钠盐或者放宽钠盐的摄入，可有效防止低钠血症及并发症的发生，对已发生低钠血症患者口服钠盐安全有效。

Low-salt diet and hyponatremia in chronic congestive heart failure

Objective To investigate the causes, prognosis and treatments of chronic congestive heart failure （CHF） with hyponatremia. Methods 120 patients with chronic CHF at Ⅲ-Ⅳ heart function levels were randomly divided into study group and control group with 60 cases in each. The study group received standard heart failure therapy along with low-salt diet while the control group received standard heart failure therapy along with normal diet. All cases were observed for 3 months. Results In the study group, 32 cases had mild hyponatremia, 8 cases had severe hyponatremia, and 2 cases died of severe hyponatremia with alkalosis and deterioration of heart function. In the control group, 2 cases suffered from mild hyponatremia but no cases had sever hyponatremia and died. Conclusion For CHF at Ⅲ-Ⅳ heart function levels, long-term or intermittent diuretic administration accompanied by proper sodium salt supply or loosening the restriction of sodium salt intake may effectively prevent hyponatremia and its complications. For the patients with hyponatremia, oral administration of sodium salt is safe and effective.