低血钾症流行病学特征及血清钾检测值与心电图改变的相关性
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摘要
目的探讨东莞常安镇低钾血症流行病学特征及血清钾检测水平与心电图改变的相关性。方法收治的700例低钾血症患者,总结流行病学特点,并分析患者血清钾测定值与心电图改变的关系。结果本组低钾血症男性占58.00%,年龄为21～30岁(50.00%),职业多为个体户(11.71%),病史以甲状腺功能亢进为主(8.86%),发病诱因主要为上呼吸道感染(21.43%),发病至就诊的时间多为6～12h(41.57%),临床表现以四肢肌肉酸痛、肌无力为主(100.0%);其中轻度低钾(血清钾水平为3.0～3.5mmol/L)占17.71%,中度低钾(血清钾水平为2.5～<3.0mmol/L)占28.57%,重度低钾(血清钾水平<2.5mmol/L)占53.71%,患者细胞计数增高比例为56.71%,心电图异常比例为94.14%,住院时间以<3d为主(89.57%);重度低钾患者心电图异常比例高于重度和轻度低钾患者;患者血钾浓度与心电图异常发生率呈负相关(P<0.05)。结论东莞常安镇低钾血症发病群体以男性、工人、青壮年为主,诱因主要为上呼吸道感染,患者常伴心电图异常改变且患者血清钾水平与心电图异常改变发生率呈负相关。
Objective To investigate the epidemiological features of hypokalemia in Changan county,Dongguan and the correlation between the detected level of serum potassium and electrocardiogram changes.Methods The epidemiological characteristics of 700 patients with hypokalemia were summarized and the relationship between the measured value of serum potassium and ECG changes were analyzed.The relationship between the detected value of serum potassium and electrocardiogram changes was analyzed.Results Male patients with hypokalemia in the study accounted for 58.00%.Most of the patients were 21-30 years old(50.00%)and self-employed entrepreneurs(11.71%).The main cause was upper respiratory tract infection(21.43%)and the time from onset to treatment was 6-12 h(41.57%).Muscular soreness of limbs and muscle weakness were main clinical manifestations(100.00%),and the proportions of mild(serum potassium concentration 3.0-3.5 mmol/L),moderate(serum potassium concentration 2.5-<3.0 mmol/L),and severe(serum potassium concentration < 2.5 mmol/L)hypokalemia were 17.71%,28.57% and 53.71%,respectively.The proportions of increased white blood cell count and abnormal electrocardiogram were 56.71% and94.14%,respectively.The hospitalization time of most patients was shorter than 3 days(89.57%).The proportion of abnormal electrocardiogram in patients with severe hypokalemia was higher than that in patients with moderate and mild hypokalemiaor(P<0.05).The serum potassium level was negatively correlated with the incidence of abnormal electrocardiogram(P<0.05).Conclusion Hypokalemia mainly occurs in male workers and young adults in Changan county,Dongguan.The main cause is upper respiratory tract infection,and most patients have abnormal electrocardiogram changes.The serum potassium level is negatively correlated with abnormal electrocardiogram changes.
Objective To investigate the epidemiological features of hypokalemia in Changan county,Dongguan and the correlation between the detected level of serum potassium and electrocardiogram changes.Methods The epidemiological characteristics of 700 patients with hypokalemia were summarized and the relationship between the measured value of serum potassium and ECG changes were analyzed.The relationship between the detected value of serum potassium and electrocardiogram changes was analyzed.Results Male patients with hypokalemia in the study accounted for 58.00%.Most of the patients were 21-30 years old(50.00%)and self-employed entrepreneurs(11.71%).The main cause was upper respiratory tract infection(21.43%)and the time from onset to treatment was 6-12 h(41.57%).Muscular soreness of limbs and muscle weakness were main clinical manifestations(100.00%),and the proportions of mild(serum potassium concentration 3.0-3.5 mmol/L),moderate(serum potassium concentration 2.5-<3.0 mmol/L),and severe(serum potassium concentration < 2.5 mmol/L)hypokalemia were 17.71%,28.57% and 53.71%,respectively.The proportions of increased white blood cell count and abnormal electrocardiogram were 56.71% and94.14%,respectively.The hospitalization time of most patients was shorter than 3 days(89.57%).The proportion of abnormal electrocardiogram in patients with severe hypokalemia was higher than that in patients with moderate and mild hypokalemiaor(P<0.05).The serum potassium level was negatively correlated with the incidence of abnormal electrocardiogram(P<0.05).Conclusion Hypokalemia mainly occurs in male workers and young adults in Changan county,Dongguan.The main cause is upper respiratory tract infection,and most patients have abnormal electrocardiogram changes.The serum potassium level is negatively correlated with abnormal electrocardiogram changes.
引文
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[6] OSNAYA-ROMERO N,ACOSTA-SAAVEDRA L C,GOYTIA-ACEVEDO R,et al.Serum level of scorpion toxins,electrolytes and electrocardiogram alterations in Mexican children envenomed by scorpion sting[J].Toxicon,2016,122(1):103-108.
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[8]张倩,王春梅,艾辉,等.急性ST段抬高型心肌梗死患者早期低钾血症的发生情况及其与短期预后的相关性研究[J].中国医药,2016,11(7):945-948.
[9]穆小萍,卢春敏,刘紫菱,等.血气分析仪与干化学仪测定血钾离子结果比较[J].国际检验医学杂志,2014,35(21):2951-2952.
[10]ASMAR A,MOHANDAS R,WINGO C S.A physiologic-based approach to the treatment of a patient with hypokalemia[J].Am J Kidney Dis,2012,60(3):492-497.
[11]何崇辉,张有猛,邵斌,等.青中年人群猝死与低钾血症的相关性分析[J].中国医师进修杂志,2016,39(4):333-336.
[12]周军荣,王晋丽.心电图对低钾血症的快速评价作用[J].中国急救医学,2011,31(7):652-654.
[13]KARMAKAR S,PADMAN A,SWAMY M N,et al.Hypokalemia:apotent risk for QTc prolongation in clarithromycin treated rats[J].Eur J Pharmacol,2013,709(1):80-84.
[2]王萍,王宇朋,沈爱东,等.低钾血症特殊心电图表现一例[J].中国全科医学,2011,14(35):4118-4119.
[3]马晓华,李萍,张启高.高钾血症致窦室传导患者的临床及心电图分析[J].医学研究生学报,2011,24(11):1231-1232.
[4]李益民,何胜虎,陈述,等.高钾血症合并心电图ST-T改变一例[J].中华内科杂志,2012,51(8):652-653.
[5]朱海云.低钾性束支阻滞的心电图临床观察[J].中国地方病防治杂志,2014,10(Z1):114.
[6] OSNAYA-ROMERO N,ACOSTA-SAAVEDRA L C,GOYTIA-ACEVEDO R,et al.Serum level of scorpion toxins,electrolytes and electrocardiogram alterations in Mexican children envenomed by scorpion sting[J].Toxicon,2016,122(1):103-108.
[7]赵晖,翟龙,张爱芳.339例血钾异常患者的心电图分析[J].中国医师进修杂志,2016,39(10):932-934.
[8]张倩,王春梅,艾辉,等.急性ST段抬高型心肌梗死患者早期低钾血症的发生情况及其与短期预后的相关性研究[J].中国医药,2016,11(7):945-948.
[9]穆小萍,卢春敏,刘紫菱,等.血气分析仪与干化学仪测定血钾离子结果比较[J].国际检验医学杂志,2014,35(21):2951-2952.
[10]ASMAR A,MOHANDAS R,WINGO C S.A physiologic-based approach to the treatment of a patient with hypokalemia[J].Am J Kidney Dis,2012,60(3):492-497.
[11]何崇辉,张有猛,邵斌,等.青中年人群猝死与低钾血症的相关性分析[J].中国医师进修杂志,2016,39(4):333-336.
[12]周军荣,王晋丽.心电图对低钾血症的快速评价作用[J].中国急救医学,2011,31(7):652-654.
[13]KARMAKAR S,PADMAN A,SWAMY M N,et al.Hypokalemia:apotent risk for QTc prolongation in clarithromycin treated rats[J].Eur J Pharmacol,2013,709(1):80-84.