临床医生必须了解貌似缺钾是由于钾从细胞外转移到细胞内所引起的。鉴别真正缺钾或貌似缺钾是很重要的,因为在治疗时,后者并不需要补钾。重要的线索在于临床表现和可靠而必要的实验检查(包括血浆pH值、尿钾和氯化物的测定)。在某些情况下,还要估计肾素—醛固酮系统的水平。一、低钾血症的类型 (一) 不缺钾的低钾血症能改变钾的细胞转移分布的原因有以下几种: 1.硷中毒机体钾正常的病人,如兼有硷中毒是容易出现低钾血症的。尽管代谢性硷中毒一般会伴随钾的短缺,然而,慢性呼吸性硷中毒是不会引起明显的低血钾的。 2.胰岛素过量 Clinicians must understand that seemingly potassium deficiency is caused by the transfer of potassium from the cell to the cell. It is important to identify true potassium deficiency or seemingly potassium deficiency because the latter does not require potassium during treatment. Important clues lie in clinical manifestations and reliable and necessary laboratory tests (including plasma pH, urine potassium and chloride determination). In some cases, the level of the renin-aldosterone system also needs to be estimated. First, the type of hypokalemia (A) Not potassium deficiency hypokalemia can change the distribution of potassium cell migration for the following reasons: 1. Alkaline poisoning in patients with normal potassium, such as both alkaline poisoning is easy Hypokalemia appears. Although metabolic alkalosis is generally accompanied by a shortage of potassium, chronic respiratory alkalosis does not cause significant hypokalemia. Insulin overdose