摘要
目的:分析内分泌疾病致低血钾、血钾浓度与临床表现、心电图变化的相关性,并观察补钾治疗后血钾和心电图恢复情况。方法:观察42例内分泌疾病引起低血钾临床表现的患者血钾浓度与心电图变化的关系,其中24例全程跟踪补钾治疗中及治疗后的临床表现、血清钾浓度和心电图变化。结果:42例低血钾患者临床表现为乏力(以双下肢为重)、心悸、胸闷,严重低血钾者表现为四肢软瘫及肌肉酸痛。血钾浓度为(2.60±0.55)mmol/L,心电图低血钾改变与血清钾生化测定符合率为88.2%,血清钾<2.5mmol/L时,两者符合率为100%。11例原发性醛固酮增多症患者入院时血钾(2.54±0.6)mmol/L;补钾治疗40h后血钾(3.35±0.44)mmol/L,血钾浓度、临床表现及心电图恢复正常时间较长。8例糖尿病酮症酸中毒或糖尿病合并高血压患者入院时血钾(2.58±0.42)mmol/L;补钾治疗40h后血钾(3.72±0.17)mmol/L,血清钾浓度、临床表现及心电图恢复正常所需时间也较长。5例甲亢周期性麻痹患者入院时血钾最低,为(1.75±0.60)mmol/L;补钾治疗15h后血钾(3.55±0.53)mmol/L,血清钾浓度、临床表现及心电图恢复正常需要的时间较原发性醛固酮增多症组或糖尿病酮症酸中毒组短。结论:低血钾的临床表现、与血清钾浓度以及心电图改变之间没有明显相关性。临床表现除与低钾?
Objective To analyze the correlation among the serum potassium, the manifestations and the electrocardiograph(ECG) changes in patients with hypokalemia caused by endocrine disease, and to observe the restoration of the serum potassium and ECG after potassium supplementation. Methods The relationship among the serum potassium, the manifestations and ECG changes during the attacks was observed in 42 patients with hypokalemia caused by endocrine disease. The manifestations, the serum potassium and ECG during and after potassium supplementation were followed up in 24 patients. Results The manifestation of hypokalemia in all the patients were characterized by fatigue (especially in the lower limbs), palpation and chest compression, while paralysis of limbs and the myosalgia were manifested in severe cases. When the serum potassium was in the range of (2.60±0.55) mmol/L, the coincidence between serum potassium and ECG changes was 88.23%; when under 2.5 mmol/L, the coincidence was 100%. In primary aldosteronism, the basal value of the serum potassium was (2.54±0.6) mmol/L; after potassium supplementation for 40 hours, the serum potassium was elevated to (3.35±0.44) mmol/L and the restorations of the manifestations, the serum potassium and ECG to normal in the patients were slower than those in the healthy. In diabetes with ketoacidosis(DKA) or diabetes with hypertension, the basal value of the serum potassium was (2.58±0.42) mmol/L; after 40 hours of supplementation, the serum potassium was( 3.72±0.17) mmol/L. Compared with those in the healthy adults, the restorations of the serum potassium, the manifestations and ECG were also slower. In thyrotoxic periodic paralysis, the basal value of the serum potassium was (1.75±0.60) mmol/L; after 15 hours of therapy, the serum potassium was( 3.55±0.53) mmol/L and the recovery of the serum potassium, the manifestations and ECG was faster than that in primary hyperaldosteronism and diabetes. Conclusions There is no significant correlation among the manifestations
出处
《诊断学理论与实践》
2004年第3期206-209,共4页
Journal of Diagnostics Concepts & Practice
