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本文报告1例轻度肾功能不全的老年人,长期口服炎痛喜康引起明显的高钾血症。男性患者,85岁,用炎痛喜康(20mg/d)治疗右踝关节炎8个月。因昏厥入院,血压155/75mmHg,血清钠135mEq/L,钾9.3mEq/L,氯化物122mEq/L。尿钠浓度76mEq/L,两次尿钾浓度分别为8和13mEq/L。停用炎痛喜康,静脉注射低渗盐水,每日口服聚苯乙烯磺酸钠,维持血清钾于5.5mEq/L。随后监测了血浆肾素活性和醛固酮浓度。纠治高钾血症及高氯血性酸中毒后,出院口服氟氢可的松0.2mg/d。
This article reports a case of mild renal insufficiency in the elderly, long-term oral Yan Tong Kang caused significant hyperkalemia. Male patient, 85 years old, had right ankle arthritis for 8 months with piroxicam (20 mg / d). Due to fainting admission, blood pressure 155 / 75mmHg, serum sodium 135mEq / L, potassium 9.3mEq / L, chloride 122mEq / L. Urinary sodium concentration of 76mEq / L, urinary potassium concentrations were 8 and 13mEq / L. Stop Yili Kang, intravenous infusion of hypotonic saline, daily oral sodium polystyrene sulfonate, serum potassium to maintain 5.5mEq / L. Plasma renin activity and aldosterone concentrations were subsequently monitored. Correction of hyperkalemia and hyperchlorosis acidosis, discharge of hydrocortisone 0.2mg / d.