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題 名 | 低血鉀的診斷與治療=Diagnosis and Treatment of Hypokalemia |
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作 者 | 李忠政; 黃文德; 林石化; | 書刊名 | 內科學誌 |
卷 期 | 22:1 2011.02[民100.02] |
頁 次 | 頁31-39 |
分類號 | 415.597 |
關鍵詞 | 低血鉀; 心律不整; 鉀離子的排泄量; 醛固酮; Hypokalemia; Cardiac arrhythmias; Potassium K+ excretion; Aldosterone; |
語 文 | 中文(Chinese) |
中文摘要 | 人體內鉀離子(K+) 靠細胞間快速的轉移,與腎臟調節每日鉀離子的排泄,來維持急性與 慢性的恆定。低血鉀(hypokalemia) 主要為鉀離子大量快速往細胞內移動,或腎臟及非腎臟因 素的鉀離子流失過多所導致。低血鉀可能會增加心臟血管疾病患者的罹病率及死亡率,導致 心律不整(cardiac arrhythmias)、肌肉癱瘓甚至呼吸停止,因此如何快速的診斷與治療低血鉀 是本篇探討的主題。其病因可以依尿液鉀離子的排泄量(potassium (K+) excretion)、血中酸鹼 值、血壓高低、血漿腎素活性(renin activity)、醛固酮(aldosterone) 濃度、皮質類固醇(cortisol) 濃度,及尿液中鈉離子與氯離子的濃度而進一步鑑別診斷。低尿液鉀離子排泄可為鉀離子急 性往細胞內移動,腸道鉀離子流失或之前腎臟過度排泄所引起。而高尿液鉀離子排泄則通常 合併有酸鹼異常。低血鉀的治療,主要取決於低血鉀的程度、造成低血鉀的快慢、臨床症狀、 潛在病因及其他相關的潛在危險因子。 |
英文摘要 | The concentration of potassium (K+) in plasma is determined on a rapid distribution of K+ between intracellular and extracellular fluid (ECF) compartments and on a day-to-day basis by the renal excretion of K+. Accordingly, hypokalemia usually arises from a shift of K+ into cells and/or excessive renal (or extrarenal) K+ loss. Further, hypokalemia is associated with increased morbidity and mortality in patients with cardiovascular disease. It may provoke cardiac arrhythmias and/or respiratory arrest. Our aim is to suggest better diagnostic tools and therapeutic principles. The measurement of urine K+ excretion rate by spot and/or 24-hour urine to evaluate K+ excretion, the acid-base status in blood, the level of blood pressure, plasma renin activity, plasma aldosterone concentration, cortisol levels and the urine sodium (Na+) and chloride (Cl-) concentration can help differentiate among the various causes of hypokalemia. In patients with a low rate of K+ excretion, hypokalemia can be explained by an acute shift of K+ into cells, intestinal K+ loss, or prior renal K+ excretion. Patients with a high rate of K+ excretion usually have metabolic acid-base disorders. The treatment of hypokalemia depends on the degree and timing of hypokalemia, clinical manifestations, the underlying causes, and potential risks attributable to associated conditions. |
本系統中英文摘要資訊取自各篇刊載內容。