中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
13期
20-23
,共4页
汪丽%苗志林%袁龙%关汝明%侯爱洁
汪麗%苗誌林%袁龍%關汝明%侯愛潔
왕려%묘지림%원룡%관여명%후애길
低钾血症%心肌梗死%经皮冠状动脉介入治疗
低鉀血癥%心肌梗死%經皮冠狀動脈介入治療
저갑혈증%심기경사%경피관상동맥개입치료
Hypokalemia%Myocardial infarction%Percutaneous coronary intervention
目的 探讨伴低血钾的急性心肌梗死(AMI)患者的临床特点和低血钾对预后的影响.方法 收集行急诊经皮冠状动脉介入治疗(PCI)的急性ST段抬高型心肌梗死患者216例,根据入院后即刻血钾水平分为A组(血钾＜3.5mmol/L,67例)和B组(血钾≥3.5mmol/L,149例).比较两组患者梗死部位、梗死相关血管及肌酸激酶同工酶MB(CK-MB)、心肌肌钙蛋白T(cTnT)峰值水平的差异,观察两组患者住院期间梗死后心绞痛、心律失常、心力衰竭及心脏性猝死的发生情况.结果 (1)A组广泛前壁、前壁梗死率和梗死相关血管为前降支率均高于B组[61.2%(41/67)比44.3%(66/149),55.2%(37/67)比38.9%(58/149)],差异有统计学意义(P=0.022、0.026).A组CK-MB、cTnT峰值高于B组[(194.39±101.27)μg/L比(115.35 ± 78.62) μg/L,(19.16 ± 11.48) μg/L比(9.07 ± 7.65) μg/L],差异有统计学意义(P=0.004、0.002).(2)A组左室射血分数低于B组(P=0.003),A组梗死后心绞痛、室性心动过速、心室颤动及心力衰竭的发生率[分别为 43.3%(29/67)、32.8%(22/67)、11.9%(8/67)、37.3%(25/67)]均高于B组[分别为24.8%(37/149)、18.1%(27/149)、4.0%(6/149)、20.8%(31/149)],差异有统计学意义(P=0.006、0.017、0.029、0.010).结论 低血钾与AMI患者的梗死部位、梗死相关血管有关,并影响患者的预后.
目的 探討伴低血鉀的急性心肌梗死(AMI)患者的臨床特點和低血鉀對預後的影響.方法 收集行急診經皮冠狀動脈介入治療(PCI)的急性ST段抬高型心肌梗死患者216例,根據入院後即刻血鉀水平分為A組(血鉀＜3.5mmol/L,67例)和B組(血鉀≥3.5mmol/L,149例).比較兩組患者梗死部位、梗死相關血管及肌痠激酶同工酶MB(CK-MB)、心肌肌鈣蛋白T(cTnT)峰值水平的差異,觀察兩組患者住院期間梗死後心絞痛、心律失常、心力衰竭及心髒性猝死的髮生情況.結果 (1)A組廣汎前壁、前壁梗死率和梗死相關血管為前降支率均高于B組[61.2%(41/67)比44.3%(66/149),55.2%(37/67)比38.9%(58/149)],差異有統計學意義(P=0.022、0.026).A組CK-MB、cTnT峰值高于B組[(194.39±101.27)μg/L比(115.35 ± 78.62) μg/L,(19.16 ± 11.48) μg/L比(9.07 ± 7.65) μg/L],差異有統計學意義(P=0.004、0.002).(2)A組左室射血分數低于B組(P=0.003),A組梗死後心絞痛、室性心動過速、心室顫動及心力衰竭的髮生率[分彆為 43.3%(29/67)、32.8%(22/67)、11.9%(8/67)、37.3%(25/67)]均高于B組[分彆為24.8%(37/149)、18.1%(27/149)、4.0%(6/149)、20.8%(31/149)],差異有統計學意義(P=0.006、0.017、0.029、0.010).結論 低血鉀與AMI患者的梗死部位、梗死相關血管有關,併影響患者的預後.
목적 탐토반저혈갑적급성심기경사(AMI)환자적림상특점화저혈갑대예후적영향.방법 수집행급진경피관상동맥개입치료(PCI)적급성ST단태고형심기경사환자216례,근거입원후즉각혈갑수평분위A조(혈갑＜3.5mmol/L,67례)화B조(혈갑≥3.5mmol/L,149례).비교량조환자경사부위、경사상관혈관급기산격매동공매MB(CK-MB)、심기기개단백T(cTnT)봉치수평적차이,관찰량조환자주원기간경사후심교통、심률실상、심력쇠갈급심장성졸사적발생정황.결과 (1)A조엄범전벽、전벽경사솔화경사상관혈관위전강지솔균고우B조[61.2%(41/67)비44.3%(66/149),55.2%(37/67)비38.9%(58/149)],차이유통계학의의(P=0.022、0.026).A조CK-MB、cTnT봉치고우B조[(194.39±101.27)μg/L비(115.35 ± 78.62) μg/L,(19.16 ± 11.48) μg/L비(9.07 ± 7.65) μg/L],차이유통계학의의(P=0.004、0.002).(2)A조좌실사혈분수저우B조(P=0.003),A조경사후심교통、실성심동과속、심실전동급심력쇠갈적발생솔[분별위 43.3%(29/67)、32.8%(22/67)、11.9%(8/67)、37.3%(25/67)]균고우B조[분별위24.8%(37/149)、18.1%(27/149)、4.0%(6/149)、20.8%(31/149)],차이유통계학의의(P=0.006、0.017、0.029、0.010).결론 저혈갑여AMI환자적경사부위、경사상관혈관유관,병영향환자적예후.
Objective To investigate clinical characteristics of patients with ST-elevation myocardial infarction (STEMI) and hypokalemia and the effects of hypokalemia on prognosis. Methods Consecutive 216 cases with STEMI who underwent emergency PCI were divided into group A (serum potassium ＜ 3.5 mmol/L) and group B (serum potassium＞3.5 mmol/L). Infarct site, infarct interrelated artery, peak level of CK-MB and cTnT were compared between two groups. Post-infarctional angina pectoris, arrhythmia, heart failure and cardiac death were compared. Results (1 )The percentage of anterior wall myocardial infarction , left anterior descending artery (LAD) lesions in group A were significantly higher than those in group B [61.2%(41/67) vs. 44.3%(66/149),55.2%(37/67)vs. 38.9%(58/149),P = 0.022,0.026]. The peak levels of CK-MB and cTnT in group A were significantly higher than those in group B [(194.39 ± 101.27) μg/L vs. (115.35 ±78.62)μg/L,(19.16 ±11.48)μg/L vs. (9.07 ±7.65) μg/L,P = 0.004,0.002].(2)Left ventricular ejection fraction in group A was significant lower than that in group B (P - 0.003). The incidence rates of post-infarctional angina pectoris, ventricular tachycardia, ventricular fibrillation and heart failure were significantly higher in group A [43.3%(29/67),32.8%(22/67), 11.9%(8/67),37.3%(25/67)] than those in group B [24.8%(37/149),18.1%(27/149),4.0%(6/149),20.8%(31/149)](P = 0.006, 0.017, 0.029, 0.010). Conclusions Hypokalemia is associated with infarct site and infarct interrelated artery. Hypokalemia has bad effect on prognosis of STEMI.
