高钾血症对急性心肌梗死患者预后的影响

张美燕; 王春梅; 许明正; 李伟; 张颖; 蒋森; 白建文

doi:10.13201/j.issn.1001-1439.2017.02.012

高钾血症对急性心肌梗死患者预后的影响

- 同济大学附属东方医院急诊内科(上海, 200120)

详细信息

通讯作者: 白建文,E-mail:jianwenbai1019@126.com

中图分类号: R542.2

收稿日期: 2016-08-04

修回日期: 2016-12-11

Effects of hyperkalemia on the prognosis of patients with acute myocardial infarction

- Department of Internal Medicine, Emergency Center, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China

More Information

Corresponding author: BAI Jianwen, E-mail: jianwenbai1019@126.com

Received Date: 04 August 2016

Revised Date: 11 December 2016

摘要

摘要: 目的:探讨高钾血症的发病率以及高钾血症与急性心肌梗死(AMI)患者预后之间的关系。方法:回顾性分析我院心内科196例AMI住院患者的资料,评价其住院期间血钾水平与院内病死率之间的关系以及纠正血钾异常是否有利于AMI患者的预后。根据血钾水平分组,将所有患者分为＜5.0 mmol/L、5.0~＜5.5 mmol/L,5.5~＜6.0 mmol/L,≥6.0 mmol/L 4组,分别分析其院内病死率。结果:196例AMI患者中高钾血症发病率为22.4%,中、重度高钾血症发病率为8.2%。高钾血症患者住院6~12 d,平均7.5 d;非高钾血症患者住院4.0~7.0 d,平均5.0 d。与非高钾血症患者相比,高钾血症患者院内病死率较高[优势比(OR)=6.57, 95%可信区间(CI):2.37~18.24, P＜0.01]。未纠正血钾异常增加AMI患者院内病死率(OR=4.67, 95% CI:1.10~19.85, P＜0.01)。多元回归分析显示,急性肾损伤是导致高钾血症的高风险因素。结论:AMI患者中高钾血症较常见,随着血钾水平升高,院内病死率也逐渐增高。临床上积极处理高钾血症可能有利于改善AMI患者的预后。
- 急性心肌梗死 /
- 高血钾症 /
- 预后
Abstract: Objective:In order to investigate the relationship between the incidence of hyperkalemia and the prognosis of patients with acute myocardial infarction (AMI).Method: A retrospective analysis of clinical data of 196 patients hospitalized with AMI in Shanghai Changzheng Hospital was conducted to evaluate the relationship between hyperkalemia, and in-hospital mortality. According to serum potassium levels, all the patients were divided into four groups: ＜5.0 mmol/L, 5.0~＜5.5 mmol/L, 5.5~＜6.0 mmol/L, and ≥6.0 mmol/L. The in-hospital mortality of these patients were analyzed respectively. Result: The incidence of hyperkalemia was 22.4%, among which the incidence of moderate to severe hyperkalemia was 8.2%. The average length of hospitalization in patients with hyperkalemia was 7.5 d (IQR, 6~12), which was 5.0 d (IQR, 4.0~7.0) among patients with no hyperkalemia. In-hospital mortality was much higher in patients with hyperkalemia compared with those with no hyperkalemia [odds ratio(OR)=6.57, 95%confidence interval(CI):2.37~18.24, P＜0.01]. Uncorrected abnormal serum potassium lead to the increase of in-Hospital mortality in patients with AMI (OR=4.67, 95% CI:1.10~19.85, P＜0.01).Conclusion:Hyperkalemia is common in patients with AMI. In-hospital mortality increases gradually along with the elevation of serum potassium levels. Actively treating hyperkalemia in clinical may contribute to the better prognosis of patients with AMI. Multiple linear regression analyses show that acute kidney injury is the biggest risk factor of hyperkalemia.
- acute myocardial infarction /
- hyperkalemia /
- prognosis

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