氯化钾缓释片对充血性心力衰竭104例的保钾疗效

充血性心力衰竭患者１０４例（正在使用地高辛加排钾利尿剂）随机均分为氯化钾缓释片（Ｓｌｏｗ－Ｋ）及普通氯化钾片（ＲＫＣｌ）２组进行保钾治疗２ｗｋ,而后改换进入另１组作自身对照。结果：Ｓｌｏｗ－Ｋ组治疗１ｗｋ末血钾即显著增加,服药承受性较好;ＲＫＣｌ组治疗２ｗｋ末血钾才显著增加,且服药承受性较差,不良反应高达２６．９％。＊Ｐ＜０．０１。±２８９ｍｇ／ｄ）。在验证过程中所用利尿剂剂量不变。３观察项目服药前测血钾（Ｋ）、钠（Ｎａ）、氯（Ｃｌ）、肌酐（Ｃｒ）、尿素氮（ＢＵＮ）和心电图。服药后每１ｗｋ复查Ｋ,Ｎａ,Ｃｌ和心电图,每２ｗｋ加复查Ｃｒ和ＢＵＮ。结果Ｓｌｏｗ－Ｋ组１０４例患者全部完成研究。ＲＫＣｌ组在研究过程中共脱落１３例（其中坚持出院者３例,心衰严重救治无效而死亡３例,因胃肠道不良反应难以耐受而改服Ｓｌｏｗ－Ｋ导致研究中断者７例）,故能完成统计分析者为９１例。血清电解质治疗前后的变化２组治疗前的血Ｋ＋参数总体看来尚属正常范围,可能是由于在住院后短时间内测定血Ｋ＋,．所用排Ｋ＋利尿剂时间不长的关系。其中只有５例的血Ｋ＋在２－３ｍｍｏｌ／Ｌ的低水平。加服Ｓｌｏｗ－Ｋ片或ＲＫＣｌ片后,均能有效地使患者的血Ｋ＋提升?

Effect of slow-release potassium chloride tablet replacement therapy of congestive heart failure in 104 patients

Digoxin and potassium-depleting diuretics were used to treat 104 patients with congestive heart failure,who were randomly divided into 2 groups:slow-release potassium chloride(Slow-K)tablet and regular potassium chloride(RKCl) tablet replacing groups.After 2 wk of potassium(K+)replacing therapy with either preparation and 3 d of "wash out",the patients were switched to the other preparation. Serum potassium(K+),sodium(Na+),chloride(Cl-),creatinine,urea nitrogen and ECG were compared in the same patient.Results demonstrated that serum K+ increased at the end of 1 wk of Slow-K therapy(P<0.05)and was further elevated at the end of 2 wk of Slow-K medication(P<0.01),while serum K+ was unchanged during the 1 wk RKCl therapy(P>0.05),and was elevated only at the end of 2 wk of RKCl medication(P<0.05).Slow-K administration showed good compliance from lack of adverse reaction(ADR),while the compliance for RKCl was poor due to severe ADR in 26.9% of patients.