急性脑出血患者低血钾发生情况及其与短期预后的关系  

The incidence of hypokalemia in patients with acute intracerebral hemorrhage and its relationship with short-term prognosis

作　　者：周永芳 伍国锋 董文涛 付江泉 韦卫琴 ZHOU Yongfang;WU Guofeng;DONG Wentao;FU Jiangquan;WEI Weiqin(Department of Emergency,Affiliated Hospital of Guizhou Medical University,Guiyang,Guizhou 550004,China)

机构地区：[1]贵州医科大学附属医院急诊科,贵阳550004

出　　处：《重庆医学》2023年第7期961-966,共6页Chongqing medicine

基　　金：国家自然科学基金面上项目(81971126/H0913);贵州省卫生健康委员会科学技术基金项目(gzwkj2023-263)。

摘　　要：目的探讨急性脑出血患者入院低血钾发生情况、影响因素及其与短期预后的关系。方法采用回顾性统计方法,以纳入该院2019年1月至2020年12月收治的急性脑出血患者359例作为脑出血组,纳入同时期性别、年龄相匹配的健康人群294例作为健康对照组,比较2组患者的血钾水平。进一步将急性脑出血患者根据血钾水平分为正常血钾组(血钾3.5~5.5 mmol/L)和低血钾组(血钾<3.5 mmol/L),分析影响急性脑出血患者低血钾的相关因素。追踪脑出血患者30 d预后,以改良Rankin量表(mRS)评分将患者分为预后不良组(3~6分)和预后良好组(0~<3分),分析急性脑出血患者血钾水平与短期预后的关系。结果急性脑出血患者血钾水平明显低于健康对照组[(3.72±0.49)mmol/L vs.(4.06±0.34)mmol/L,P<0.05];急性脑出血患者中低血钾组108例,正常血钾组251例,低血钾发生率30.1%,二元logistic回归分析表明,性别[OR=0.440,95%CI(0.293,0.777)]、入院NIHSS评分[OR=1.043,95%CI(1.019,1.068)]、尿素氮[OR=0.849,95%CI(0.753,0.958)]为急性脑出血患者发生低血钾的独立影响因素;预后良好组与预后不良组血钾水平比较[(3.73±0.43)mmol/L vs.(3.69±0.44)mmol/L],差异无统计学意义(P>0.05),发病30 d死亡组与存活组血钾水平比较[(3.57±0.44)mmol/L vs.(3.73±0.43)mmol/L],差异有统计学意义(P<0.05),二元logistic回归分析发现低血钾不是急性脑出血患者发病30 d死亡的独立危险因素。结论急性脑出血患者易出现低钾血症,女性、入院NIHSS评分越高、尿素氮水平越低的急性脑出血患者低血钾发生率越高;发病30 d死亡的急性脑出血患者血钾水平较存活患者更低,但低血钾不能预测急性脑出血患者短期不良预后。Objective To investigate the incidence of hypokalemia in patients with acute cerebral hemorrhage,its influencing factors and its relationship with short-term prognosis.Methods A total of 359 patients with acute intracerebral hemorrhage admitted to this Hospital from January 2019 to December 2020 were enrolled as the intracerebral hemorrhage group by retrospective statistical method,and 294 healthy people with matched gender and age at the same period were included as the normal control group,and serum potassium levels of the two groups were compared.Further,the patients with acute intra cerebral hemorrhage were further divided into the normal blood potassium group(blood potassium 3.5-5.5 mmol/L)and the hypokalemia group(blood potassium<3.5 mmol/L)according to the serum potassium level,and the related factors affecting hypokalemia in patients with acute intra cerebral hemorrhage were analyzed.Follow up the prognosis of patients with intracerebral hemorrhage for 30 days,and divide them into the good prognosis group(0-<3 points)and the poor prognosis group(3-6 points)according to the modified Rankin Scale(mRS)score,the relationship between serum potassium level and short-term prognosis of patients with acute intracerebral hemorrhage was analyzed.Results The serum potassium level in patients with acute intracerebral hemorrhage was significantly lower than that in the normal control group[(3.72±0.49)mmol/L vs.(4.06±0.34)mmol/L,P<0.05].108 patients with acute intra cerebral hemorrhage were admitted to the hypokalemia group and 251 patients to the normal blood potassium group.The incidence of hypokalemia was 30.1%.Binary logistic regression analysis showed that gender[OR=0.44,95%CI(0.293,0.777)],admission NIHSS score[OR=1.043,95%CI(1.019,1.068)],and urea nitrogen[OR=0.849,95%CI(0.753,0.958)]were independent influencing factors for hypokalemia in patients with acute intracerebral hemorrhage.There was no statistically significant difference in serum potassium levels between the good prognosis group and the poor prognosi

关 键 词：急性脑出血 低血钾症 预后 死亡率 

分 类 号：R743.34[医药卫生—神经病学与精神病学]