Alright, so there are all these ways to develop hypokalemia, but what happens when somebody has hypokalemia?

好，这些就是所有形成血症的途径了，但是当一个人血症时会发生什么呢？

In patients with severe hypokalemia, the main goal of treatment is to normalize potassium levels.

对于严重血症的病人，治疗的目标是使得血水平正常。

Finally, hypokalemia can affect cardiac muscle contractions, which can lead to cardiac arrhythmias and cardiac arrest.

最后，血症会影响心肌收缩，导致心律失常和心搏骤停。

That said, simply low intake can lead to hypokalemia, like in anorexia, prolonged fasting, or specific types of diets.

即未摄入足量的会导致血症，比如厌食症、长期禁食，或者特定类型的饮食。

In rare cases, insulin overdose can cause enough potassium uptake into cells as to cause hypokalemia.

罕见案例，胰岛素过量会造成足量的被细胞摄入，造成血症。

Commonly used diuretics, like loop diuretics and thiazide diuretics, also increase potassium excretion and can lead to hypokalemia.

通常使用的利尿剂，比如袢利尿剂和噻嗪类利尿剂，也会增加的排泄，导致血症。

Alright, on to external potassium balance shifts resulting in hypokalemia, which has to do with potassium intake or excretion.

好，那导致血症的外部平衡的化，和摄入和排泄有关。

Early ECG changes in hypokalemia are mainly due to delayed ventricular repolarization.

血症早期心电图改是心室复极延迟所致。

JW also has hypokalemia, or low potassium presence in blood because of that beer.

JW也有血症，或者因为饮用大量啤酒导致血液的被稀释。

Another external balance shift causing hypokalemia is increased losses of gastrointestinal secretions, typically due to vomiting and diarrhea.

另一种导致血症的外部平衡化是胃肠道消化液的大量丢失，典型原因是呕吐和腹泻。

But the loss of stomach acid leads to metabolic alkalosis, which as we saw, can lead to hypokalemia.

但是胃酸的丢失导致代谢性碱毒，如我们所见，可以导致血症。

Most commonly, hypokalemia is caused by excessive loss of potassium in the urine from the GI tract or skin.

最常见的血症是由胃肠道或皮肤尿液过度流失引起的。

The low potassium or hypokalemia is particularly worrisome because it can lead to muscle weakness and even cardiac arrhythmias, the latter of which can lead to death.

其血是尤其危险的，因为它能导致肌无力甚至心律失常，后者可危及生命。

So in order to help compensate for an alkalosis, hydrogen ions leave cells and potassium ions enter the cells and leave the blood, resulting in hypokalemia.

所以，为了帮助碱毒的代偿，氢离子离开细胞，而离子离开血液、进入细胞，导致血症。

Individuals with hyperaldosteronism typically develop hypertension related symptoms like headaches and facial flushing, as well as hypokalemia related symptoms like constipation, weakness, and potentially changes in their heart rhythm.

醛固酮增多症者通常会出现高血压相关症状，如头痛和面部潮红，以及血症相关症状，如便秘、乏力与对心律的潜在影响。

All that being said, in situations where somebody produces too much aldosterone, like primary hyperaldosteronism, then there's more potassium secretion by the principal cells and excreted, and therefore less potassium is retained, leading to hypokalemia.

说了这么多，在某人产生了太多醛固酮的情况下，比如原发性醛固酮增多症，更多的被细胞分泌并排泄，这意味着更少的被保留，导致了血症。

All right, as a quick recap, hyperaldosteronism is the chronic, excess secretion of aldosterone from the zona glomerulosa of the adrenal gland, and these high aldosterone levels can lead to hypokalemia, hypernatremia, hypertension, and a metabolic alkalosis.

得！简单回顾一下：醛固酮增多症是指肾上腺球状带长期分泌过多的醛固酮；这些高醛固酮水平可导致血症、高钠血症、高血压与代谢性碱毒。

As hypokalemia becomes more severe especially in patients with other heart conditions, the inward current may exceed the outward current resulting in early after depolarization and consequently extra heartbeats prolonged repolarization may also promote re-entrant arrhythmias.

随着血症得更加严重，尤其是其他心脏病者，内向电流可能会超过外向电流，从而导致早期去极化后，因此，额外的心跳延长复极也可能促进折返性心律失常。

Taken together, a relatively high potassium concentration in the principal cell and a relatively low potassium concentration in the lumen, strengthens the potassium gradient and causes a lot of potassium to get secreted and excreted in the urine - leading to hypokalemia.

总之，细胞相对高的浓度和管腔相对的浓度，强化了的浓度梯度，造成了许多被分泌和排泄入尿液，导致血症。