急性心肌梗塞早期血钾的变化分析

目的了解血清钾在急性心肌梗塞中的变化趋势及其意义。方法本文总结了我院1999年1月～2001年6月来54例急性心肌梗塞患者,分别检测其急性心肌梗塞发生12h内、13～24h、25～48h以及48h以后的血清钾浓度,并进行统计学研究,了解其动态变化趋势,以及可能的临床意义。结果①急性心肌梗塞12h内常出现一过性的血钾降低。②低血钾与急性心肌梗塞部位有相关性,累及右室合并下壁梗塞者低血钾发生率最高,其次为前壁,组间血钾差异有显著性(P<0.05),单纯下壁及下壁合并后壁梗塞者较少低血钾发生。③血钾下降程度与发生室性心律失常呈正性相关。结论急性心肌梗塞早期常伴有低血钾情况,而且合并有室性心律失常,低血钾与急性心肌梗塞部位有相关性,急性心肌梗塞在发病初期(12h内),伴随低血钾常发生室性心律失常,室性心律失常又是急性心肌梗塞死亡的主要原因之一,因此,重视和治疗急性心肌梗塞发病初期的低血钾十分重要。

Analysis on the Change of Serum Potassium in Acute Myocardial Infarction

Objective To investigate the fluctuation tendency of serum potassium in acute myocardial infarction and its clinical significance. Methods 54 cases of acute myocardial infarction patients from January 1999 to June 2001 were studied. The level of serum potassium was examined after incidence within the first 12 hours, from 13 hours to 24 hours, from 25 hours to 48 hours and over 48 hours. The statistical study was performed in order to investigate its fluctuation tendency and possible clinical significance.Results (1)The reduction of serum potassium was usually appeared within the first 12 hours in acute myocardial infarction patients. (2)The hypokalemia was correlated with the site of acute myocardial infarction. The incidence rate of hypokalemia was highest in right ventricle combined with inferior wall myocardial infarction,lower in the anterior wall myocardial infarction, and lowest in simple inferior wall and inferior wall combined with posterior wall myocardial infarction. The difference of level of serum potassium was significant(P< 0 05). (3)The reduction of the level of serum potassium was positively correlated with ventricular arrhythmia. Conclusions Acute myocardial infarction with hypokalemia usually combines with ventricular arrhythmia in early stage. The hypokalemia is correlated with the site of acute myocardial infarction. At the initial onset of acute myocardial infarction, the patients with hypokalemia usually occur ventricular arrhythmia, and ventricular arrhythmia is one of the main factors causing death. It is very important to treat hypokalemia at the initial onset of acute myocardial infarction.