摘要
目的探讨ST段抬高型心肌梗死（STEMI）患者人院时血钾（K^＋）水平与患者住院死亡率、随访期死亡率及室性心律失常的相关性。方法本研究为回顾性研究，纳入2013—06．2015—05期间在我院心内科治疗的298例因STEMI行经皮冠状动脉介入治疗（PCI）的患者。根据患者人院血K^＋水平将患者分为：K^＋〈3．5mmol／L、3．5mmol／L≤K^＋〈4mmol／L、4mmol／L≤K^＋〈4．5mmol／L、4．5mmol／L≤K^＋〈5mmol／L和≥5mmol／L组五组。以3．5mmol／L≤K^＋〈4mmol／L组为对照组，比较五组患者的临床与实验室数据、死亡率。结果3．5mmol／L≤K^＋〈4mmol／L组患者住院死亡率及随访期死亡率最低。4．5mmol／L≤K^＋〈5mmol／L组患者的住院死亡率（OR=1．89，95％CI1．28～7．41，P=0．028）与随访期死亡率（OR=2．65，95％CI1.81～8．69，P=0．015）分别是3．5mmol／L≤K^＋〈4mmol／L组患者的1．89倍与2．65倍。血K≤3．5mmol／L组（OR=2．49，95％CI1．94～6．55，P=0．003）或血K^＋〉／5．0mmol／L组（OR=4．70，95％CI1．70～13．55，P=0．045）的患者室性心律失常风险显著提高。结论STEMI患者入院血K^＋≥4．5mmol／L与随访期死亡率增加相关；血K≤3．5mmol／L或／〉5．0mmol／L与室性心律失常发生显著相关。
Objective To figure out the relation between admission serum potassium （sK） level and in-hospital and long-term mortality and ventricular arrhythmias. Methods Retrospectively, 298 patients with ST-elevation myocardial infarction （STEMI） who underwent primary percutaneous coronary intervention were recruited. According to admission sK levels they were divided into 5 groups： sK 〈 3.5, 3.5≤sK 〈 4, 4≤sK 〈 4.5, 4.5≤sK 〈 5, and sK≥5 mmol/L. Results The lowest in-hospital and long-term mortality occurred in patients with sK levels of 3.5≤sK 〈 4 mmol/L. 4.5≤sK 〈 5 mmol/L group with in-hospital mortality （OR = 1.89, 95% CI 1.28-7.41, P = 0.028） and follow-up mortality （OR = 2.65, 95% CI 1.81-8.69, P= 0.015） , were respectively 1.89 times and 2.65 times than 3.5≤ sK 〈 4 mmol/L group. Patients in sK 〈 3.5 mmol/L group （OR = 2.49, 95% CI 1.94-6.55, P = 0.003） and sK≥5 mmol/L group （OR = 4.70, 95% CI 1.70-13.55, P = 0.045） have significantly increased risk of ventricular arrhythmias. Conclusion Admission sK level of 〉14.5 mmol/L is associated with increased long-term mortality in STEMI. A significant relation is found between sK level of 〈 3.5 mmol/L and ≥5 mmol/L and ventricular arrhythmias.
出处
《中国急救医学》
CAS
CSCD
北大核心
2016年第4期333-336,共4页
Chinese Journal of Critical Care Medicine
