目的 观察环硅酸锆钠(sodium zirconium cyclosilicate,SZC)散剂对高钾血症患者的短期降钾效果及不良反应。 方法 收集2020年11月—2022年3月在西宁市第一人民医院合并高钾血症的50例住院患者服用SZC的临床资料，回顾性分析服用SZC后2小时、8小时的降钾效果及药物不良反应。 结果 患者用药后2小时、8小时静脉血钾较用药前均明显降低(t=10.034、14.654，P＜0.001)，血钠、血钙、血镁、二氧化碳结合率(CO2CP)、谷丙转氨酶(ALT)及谷草转氨酶(AST)服药前后比较差异均无统计学意义(P＞0.05),分析患者用药2小时、8小时后血钾降幅与用药前血钾水平的散点图显示呈线性正相关(r=0.298、0.579，P=0.038、＜0.001),比较GFR≤15 ml/min和＞15 ml/min2组患者服药2小时、8小时的降钾幅度差异无统计学意义(t=-1.452、1.594，P=0.153、0.118),治疗中有2例患者口服SZC出现轻度恶心。 结论 SZC可在2～8小时内能安全有效降低高钾血症患者的血钾水平，且无严重的不良反应。
Objective To observe the short-term potassium-lowering effect and adverse reactions of sodium zirconium cyclosilicate dispersion in patients with hyperkalemia. Methods The clinical data of 50 inpatients with hyperkalemia who received sodium zirconium cyclosilicate dispersion at Xining City First People's Hospital from November 2020 to March 2022 were collected and retrospectively analyzed for the potassium-lowering effects after 2 hours and 8 hours post-medication as well as any adverse drug reactions. Results Blood potassium levels after 2 hours and 8 hours post-medication were significantly lower than those before medication (t=10.034 and 14.654, P＜0.001), while there were no significant differences in blood sodium, calcium, magnesium, CO2CP, ALT, and AST levels before and after medication (P>0.05). Scatter plot analysis showed a linear positive correlation between the degree of decrease in blood potassium at 2 hours and 8 hours post-medication and the pre-medication blood potassium levels (r=0.298 and 0.579, P=0.038 and ＜0.001). There was no statistically significant difference in the degree of potassium reduction between the group with GFR ≤15ml/min and the group with＞15 ml/min at both 2 hours and 8 hours post-medication (t=-1.452 and 1.594, P=0.153 and 0.118). During treatment, two patients experienced mild nausea after taking the drug. Conclusion Sodium zirconium cylcosilicate dispersion can safely and effectively reduce blood potassium levels within 2-8 hours in patients with hyperkalemia without severe adverse reactions.
