长期摄入低钠盐老年患者心血管急症的特征分析  

Characteristics of cardiovascular urgencies in patients who took low sodium salt perennially

作　　者：麦惠强[1] 刘历威 许进[3] 蓝先旗[1] 陈树鑫[1] 

机构地区：[1]中山市人民医院急诊科,广东中山528403 [2]南方医科大学第二临床学院,广州510000 [3]广州市第一人民医院病理科,广州510180

出　　处：《岭南心血管病杂志》2017年第4期451-454,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的观察长期食用低钠盐(low sodium salt,LSS)的老年患者出现心血管急症的特征。方法回顾性收集2011年1月至2016年6月中山市人民医院59例长期摄入LSS且因胸痛、心悸或胸闷而到急诊就诊的患者资料,分析其急诊血压、血生化及心电参数特征,并与73例无摄入LSS的患者作为对比。结果以上59例心血管急症的第一诊断分别为电解质紊乱(n=20)、心律失常(n=19)、血压异常(n=13)、急性冠状动脉综合征(ACS)(n=7),其中高钾血症为最常见的情形,有17例(28.81%),17例中并发低钠的有13例(22.03%),其次为并发10例窦性心动过缓(16.95%)。LSS患者收缩压、血钠浓度明显低于对照组,差异有统计学意义(P=0.031、P=0.041);但血钾浓度则显著高于对照组,差异有统计学意义(P=0.043);两组肌酐及尿素浓度比较,差异无统计学意义(P>0.05)。LSS患者的肢体及胸导联T波振幅均显著高于对照组,且QRS波时限大于对照组,差异有统计学意义(P=0.033、P=0.036、P=0.042);两组的P-R及Q-T间期比较,差异无统计学意义(P>0.05)。结论长期摄入LSS的老年患者容易出现电解质紊乱,在心血管症状急性发作时多表现为收缩压降低、T振幅及QRS波时限增大,可能与钠-钾的代谢平衡有关。Objectives To summarize the characteristics of cardiovascular urgencies in patients who took low sodium salt（LSS）perennially. Methods Clinical data of 59 patients who took LSS perennially were retrospectively analyzed （LSS group）. They went to the Emergency Department of Zhongshan People ＆#39;s Hospital from January 2011 to January 2016 because of chest tightness ,chest pain or heart palpitations. Characteristic of the ambulatory blood pressure ,blood biochemical and electrical parameters of them were measured and compare with those of 73 patients without consuming LSS（control group）. Results The first diagnosis of cardiovascular urgency were electrolyte disorder（n=20）,arrhythmia （n=19）,abnormal blood pressure （n=13）,acute coronary syndrome （ACS）（n=7）,respectively in the 59 patients. Among these cardiovascular urgencies ,hyperkalemia 17（28.81%） was the most common ,including 13 （22.03%） patients complicated with low sodium and 10 （16.95%） patients with sinus bradycardia. Systolic blood pressure and serum concentration of sodium in LSS group were significantly lower than those in control group（P=0.031,P=0.041）;but serum concentration of potassium was significantly higher than that in control group（P=0.043）;serum concentrations of creatinine and urea had no significant differences between the two groups （P〉0.05）. Limbs and chest lead T wave amplitudes in LSS group were significantly higher than those in control group ,and duration of QRS wave was greater than that in control group（P=0.033,P=0.036,P=0.042）;P-R and Q-T interphases had no significant differences between the two groups （P〉0.05）. Conclusions Elderly patients with long-term intake of LSS prone to electrolyte disorder,their systolic blood pressures decrease,T wave amplitude and duration of QRS wave increase whey they suffer from cardiovascular emergency. It may be associated with the metabolic balance of sodium and potassium.

关 键 词：心血管急症 低钠盐 老年 心电参数 血压 

分 类 号：R543[医药卫生—心血管疾病]