急性心肌梗死早期低钾血症的相关因素分析及针对性补钾治疗的临床效果  

Analysis of related factors of early hypokalemia in acute myocardial infarction and clinical effect of targeted potassium supplementation

作　　者：赵世才 ZHAO Shi-cai(Department of Cardiology,Huiyang Sanhe Hospital,Guangdong Province,Huiyang516211,China)

机构地区：[1]广东省惠阳三和医院心血管内科,广东惠阳516211

出　　处：《中国当代医药》2020年第23期65-67,71,共4页China Modern Medicine

基　　金：广东省惠州市科技计划项目(20190401)。

摘　　要：目的探究急性心肌梗死(AMI)早期低钾血症的相关因素及针对性补钾治疗的作用。方法回顾性分析我院收治的150例AMI患者,根据血钾水平分为低钾血症组(n=36),正常血钾组(n=114),对影响低钾血症的相关危险因素进行单因素及多因素非条件Logistic回归分析。低血钾组给予正常或强化补钾治疗,将低钾血症患者分为A组和B组,各18例。其中A组给予口服补钾治疗,B组则联合中心静脉补钾治疗,观察两组治疗前、治疗2~12 h后血钾浓度变化。结果单因素结果分析显示,低钾血症组和正常血钾组AMI早期发病时间、心律失常发生情况比较,差异有统计学意义(P<0.05)。多因素非条件Logistic回归模型分析结果显示,AMI早期发病时间≤6 h(β=2.012,OR=7.480,95%CI=1.001~9.040)、房室传导阻滞(β=2.032,OR=7.630,95%CI=1.002~9.110)及室颤、室速(β=2.050,OR=7.770,95%CI=1.006~10.153)均为低钾血症发生的独立危险因素(P<0.05)。A组、B组治疗后4、8、12 h的血钾浓度均高于治疗前,差异有统计学意义(P<0.05);且B组治疗后4、8、12 h的血钾浓度均高于A组,差异有统计学意义(P<0.05)。结论AMI早期发病时间≤6 h,房室传导阻滞及室颤、室速均为低钾血症发生的危险因素,而进行针对性补钾治疗,可显著提高早期低钾血症患者的血钾浓度。Objective To explore the related factors of early hypokalemia in acute myocardial infarction and the effect of targeted potassium supplementation therapy.Methods A retrospective analysis of 150 AMI patients admitted to our hospital was divided into hypokalemia group(n=36)and normal potassium group(n=114)according to blood potassium level.Univariate and multi-factor unconditional Logistic regression analysis were used to analysis the related risk factors affecting hypokalemia.The hypokalemia group was given normal or intensive potassium supplementation treatment,and hypokalemia patients were divided into groups A and B,18 cases in each group.Among them,group A was given oral potassium supplement therapy,group B was combined with central intravenous potassium supplement therapy,and the changes of blood potassium concentration before treatment and after 2 to 12 h of treatment in both groups were observed.Results The single factor analysis showed that there were significant differences between the early onset of AMI and the occurrence of arrhythmia in the hypokalemia group and the normal potassium group(P<0.05).Multi-factor unconditional Logistic regression model analysis results showed that the early onset time of AMI≤6 h(β=2.012,OR=7.480,95%CI=1.001-9.040),atrioventricular block(β=2.032,OR=7.630,95%CI=1.002-9.110),ventricular fibrillation and ventricular tachycardia(β=2.050,OR=7.770,95%CI=1.006-10.153)were all independent risk factors for hypokalemia(P<0.05).The blood potassium concentration in groups A and B after treatment at 4,8,and 12 h were all higher than those before treatment,and the differences were statistically significant(P<0.05);and after treatment at 4,8,and 12 h,the blood potassium concentrations in group B were higher than those in group A,the differences were statistically significant(P<0.05).Conclusion Early onset time of AMI≤6 h,atrioventricular block,ventricular fibrillation,and ventricular tachycardia are all risk factors for hypokalemia,and targeted potassium supplementation treatment c

关 键 词：急性心肌梗死 低钾血症 相关因素 补钾治疗 

分 类 号：R542[医药卫生—心血管疾病]