ST段抬高型心肌梗死患者血钾水平分析

目的探讨ST段抬高型心肌梗死（STEMI）患者与冠状动脉造影阴性的对照组患者血钾含量及低血钾发病率的差异。方法选取2007年1月至2008年8月间STEMI并行直接经皮冠状动脉介入术患者161例。同时选取冠状动脉造影阴性的对照组患者161例。血钾含量〈3．5mmol／L定义为低血钾。比较2组间血钾含量及低血钾发病率。结果血钾含量STEMI患者（3．96±0．47）mmol／L，低于对照者（4．03±0．41）mmol／L]，差异有统计学意义（t=-1．37，P〈0．05）。低血钾发病率STEMI（12．42％）高于对照者（6．83％）但差异无统计学意义（χ^2=2．89，P=0．1）。137例STEMI患者血钾〈4．5mmol／L。结论STEMI患者的低血钾发病率较对照组高，血钾浓度较对照组低。STEMI急性期存在血钾下降，血钾含量〈4．5mmol／L时最好静脉补钾纠正低钾血症。

Analysis of serum potassium in patients with ST-elevation myocardial infarction

Objective To compare concentrations of potassium between ST-elevation myocardial infarction (STEMI) patients and normal angiography patients. Methods One hundred and sixty-one patients (131 males and 30 females)with STEMI were studied and 161 patients (131 males and 30 females) with normal coronary arteriogram were selected as a control from January 2007 to August 2008. Plasma concentration of potassium was compared between two groups. Results Plasma concentration of potassium was lower in STEMI group(3.96± 0.47) g/L than that in control group(4.03 ±0.41)mmol/L (t = - 1.37, P < 0.05 ). Conclusion The levels of potassium in patients with STEMI are significantly lower than normal levels. Patients with AMI can have hypokalemia with poor prognosis. Intervenous administration of potassium is indicated when potassium level is below 4.5 mmol/L at the initial onset of acute myocardial infarction.