心电图对高钾血症的诊断价值

目的 探讨心电图检测对诊断高钾血症的临床价值.方法 对72例高钾血症患者的心电图与血清钾浓度进行对比分析.结果 心电图诊断高钾血症41例,与血清钾测定的符合率为56.9%;血清钾大于5.5 mmol/L时,心电图诊断高钾血症的符合率为22.2%,主要表现为T波高耸,里帐篷状;血清钾大于6.7 mmol/L时,心电图诊断高钾血症的符合率为74.3%,主要表现为ST段压低,P波振幅降低,时限增宽,部分患者出现窦.室传导,个别出现恶性室性心律失常;血清钾大于10.0 mmol/L时,心电图诊断高钾血症的符合率为100%,大部分患者表现为恶性室性心律失常.结论 心电图表现与血清钾测定有较好的一致性,当合并其他电解质失衡时,会加重心电图的异常程度;心电图可准确、简便鉴别假性高血钾.

Clinical value of electrocardiogram changes on the diagnosis of hyperkalemia

Objective To research clinical significance of electrocardiogram(ECG) measuring in diagnosis of hyperkalemia. Methods ECG changes and serum potassium concentration from 72 cases have been analyzed and contrasted. Results Forty-one cases with hyperkalemia are detected by ECG changes. Coincidence rate is up to 56.9% with serum potassium test. When the serum potassium concentration exceeds 5.5mmol/L, the accuracy of ECG in diagnosis of hyperkalemia was 22.2%. The main features arc peaked T wave with tabernacle shape ;when the serum potassium concentration exceeds 6.7mmol/L, the accuracy of ECG in diagnosis of hyperkalemia was 74.3%. The main features are ST debased,P wave with low amplitude and time limit increased. Some patients appeared sinus node-ventride conduction. One or two appeared malignant ventricular arrbythmia; when the serum potassium concentration exceeds 10.0mmol/L,the accuracy of ECG was 100% ,most patients appeared malignant ventricular. Conclusion The electrocardiogram measurement has the better consistency with serum potassium test, and abnormal electrocardio-gram will be eccurred,when mixed other electrolyte unbalance. Pseudo-hyperkalemia can be distinguished accurately and conveniently by using this method.