高钾血症对实验犬心脏结构及功能的影响——二维和脉冲多普勒超声心动图观察  

The influence of acute hyperkalemia on the structure and function of heart by twodimensional and pulsed wave Doppler echocardiography

作　　者：丛洪良[1,2,3] 王佩显[1,2,3] 王小飞 姚翠红[1,2,3] 

机构地区：[1]天津医科大学第二医院心脏科 [2]天津市心脏病学研究所 [3]天津医科大学总医院心脏科

出　　处：《中国危重病急救医学》1999年第1期24-27,共4页Chinese Critical Care Medicine

摘　　要：目的：研究高钾血症对心脏结构及功能的影响。方法：采用静脉滴注氯化钾溶液建立犬急性高钾血症模型；用二维及脉冲多普勒超声心动图研究高血钾对心脏结构及收缩、舒张功能的影响。结果：当血钾浓度从（３．７７±０．３６）ｍｍｏｌ／Ｌ升高至（６．６４±１．１７）ｍｍｏｌ／Ｌ时，左右心室径变化不大，但收缩及舒张功能已受损，且同时发生；当血钾浓度升高到（１２．８２±２．６７）ｍｍｏｌ／Ｌ，左右心室迅速扩大，左室径从（３．４１±０．４５）ｃｍ扩至（４．７０±０．２３）ｃｍ（ｔ＝４．９１，Ｐ＜０．０１），右室径从（１．６５±０．３６）ｃｍ扩至（２．７５±０．２１）ｃｍ（ｔ＝５．２３，Ｐ＜０．０１）。而左右心室的扩大均发生在高血钾致心律失常后１～２小时，心脏扩大后（０．９１±０．２２）小时犬死亡。结论：高钾血症应早期发现和早期治疗，以免导致心脏扩大。Objective:To investigate the influence of acute hyperkalemia on the structure and function of heart.Methods:A canine model of acute hyperkalemia was established to observe the effect of acute hyperkalemia on dog′s heart.12 anesthetized dogs were studied by twodimensional and pulsed wave Doppler echocardiography.6 of them were given slow intravenous infusion of 5% glucose as control group.Then 1 % potassium chloride solution was infused at a rate of 2 mg·kg -1 ·min -1 into the femoral vein as experimental group.After that,the concentration of ,EKG,transmitral and transaortic flow velocity profile were measured once every hour.Results:We found that left ventricular diastolic transmitral flow velocity patterns were monopeak [(E+A)peak].As increased,(E+A) velocity decreased,peak fill rate (PFR),normalized PFR changed respectively,and transaortic flow velocity (Va),stroke volume (SV) as well as cardiac output (CO) decreased.Thus,the systolic and diastolic function of dog′s heart were impaired simultaneously along with increasing of .During early period of the experiment,the left and right ventricular end systolic,diastolic dimension (LVESD,LVEDD,RVESD,RVEDD) showed no change,but when increased to certain extent (12 82±2 67)mmol/L ,LVESD,LVEDD,RVESD,RVEDD increased rapidly left ventricular dimension:from (3 41±0 45)cm to (4 70±0 23)cm, P <0 01;right ventricular dimension:from(1 65±0 36)cm to (2 75±0 21)cm, P <0 01 .Additionally,animals died at (0 91±0 22)hours after heart dilation.Conclusions:These findings suggest that hyperkalemia is a critical disease,which may lead to heart dilation and myocardium dysfunction.Early correction should have beneficial effect on heart structure and function.

关 键 词：高钾血症 心室结构 心肌功能 超声多普勒 

分 类 号：R589.4[医药卫生—内分泌]