甘草酸制剂诱导重度低钾血症案例报道及分析

中国医药导刊 ›› 2021, Vol. 23 ›› Issue (10): 759-763.

甘草酸制剂诱导重度低钾血症案例报道及分析

刘思彤1,2，胡杨1,2，金月波1，钟雪1*

1.北京大学人民医院，北京 100044； 2.北京大学药学院，北京 100191

收稿日期:2021-09-07 修回日期:2021-09-24 出版日期:2021-10-28 发布日期:2021-10-28
基金资助:
北京市自然科学基金资助项目（项目编号:7184254；项目名称:系统性红斑狼疮患者中基因多态性与羟氯喹血药浓度及视网膜病变相关性）；北京药学会临床药学研究项目（项目编号：2020-Z-24；项目名称：基于文献和真实世界数据评价羟氯喹血药浓度检测对预测用药安全性及依从性的意义）

Glycyrrhizin-induced Hypokalemia:A Case Report and Literature Review

1.Peking University People′s Hospital, Beijing 100044,China; 2.Peking University School of Pharmaceutical Sciences, Beijing 100191,China

Received:2021-09-07 Revised:2021-09-24 Online:2021-10-28 Published:2021-10-28

摘要/Abstract

摘要： 目的：提高临床医务人员对甘草酸制剂诱导重度低钾血症的认识、诊断及治疗水平。方法：结合1例复方甘草酸苷片引起重度低钾血症的临床案例，检索国内外甘草酸制剂引起重度低钾血症的文献，分别从药品成分、给药剂量、血钾水平、不良反应出现时间、临床表现及转归6个方面整理汇总。结果：共收集相关文献13篇，包括英文个案报道3篇，中文个案报道10篇。重度低钾血症报道最多的药物是复方甘草酸苷片，患者常表现为肌肉酸痛，也有乏力、食欲下降、心前区不适等表现。中位血钾1.8 mmoL·L-1，最低为1.3 mmoL·L-1，重度低血钾中位出现时间为使用甘草酸制剂后的60 d，最早可出现在使用药物后的4 d，最长在1年以上。在停用可能引起低钾血症的药物并给予补钾治疗的情况下，中位血钾恢复时间为7 d，最快为1 d，最慢为14 d。结论：甘草酸制剂引起低钾血症的程度、表现、时间有很大的个体差异，在临床使用含甘草酸的药物时应注意监测血钾、血压、肌酸激酶等情况，减少或避免严重不良反应的发生。

关键词: font-size:medium, ">甘草酸制剂；低钾血症；假性醛固酮增多症；案例报道

Abstract: Objective：To improve the understanding, diagnosis and treatment of severe hypokalemia induced by glycyrrhizin.Methods：Based on one case of severe hypokalemia induced by compound glycyrrhizin tablets, similar domestic and foreign reports were searched. Then characteristics of these reports were summarized from composition, dosage, potassium level, occurrence time of hypokalemia, symptoms and outcomes respectively. Results：A total of 13 reports(3 in English and 10 in Chinese) were included. The most commonly reported drug for severe hypokalemia is compound glycyrrhizin tablets. The most common symptoms of patients were muscle soreness, fatigue, decreased appetite, and precardiac discomfort. The median serum potassium was 1.8 mmoL·L-1, and the lowest was 1.3 mmoL·L-1. The median time of severe hypokalemia was 60 d after the use of glycyrrhizin preparation. The earliest appeared on the fourth day and the longest time was more than 1 year after glycyrrhizin was used. With enough potassium supplementation and discontinuation of medications that may cause hypokalemia, the median recovery time for serum potassium was 7 d. The earliest recovery time was 1 d while the longest was 14 d.Conclusion：The potassium level, symptoms and time of hypokalemia induced by glycyrrhizin have individual difference, and potassium level, blood pressure and creatine kinase should be paid attention to avoid severe adverse events.

Key words: font-size:medium, ">Glycyrrhizin, Hypokalemia, Pseudoaldosteronism；Case report

中图分类号:

刘思彤, 胡杨, 金月波, 钟雪. 甘草酸制剂诱导重度低钾血症案例报道及分析[J]. 中国医药导刊, 2021, 23(10): 759-763.

LIU Sitong, HU Yang, JIN Yuebo, ZHONG Xue. Glycyrrhizin-induced Hypokalemia:A Case Report and Literature Review[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2021, 23(10): 759-763.

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