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电解质失衡时的心电图变化。第1部分:血清钾的改变(作者译)

[Electrocardiographic changes in electrolyte imbalance. Part 1: Alterations in serum potassium (author's transl)].

作者信息

So C S, Volger E, Batrice L

出版信息

Med Klin. 1975 Oct 17;70(42):1689-96.

PMID:1186576
Abstract

163 patients (95 hypokalemic, 48 hyperkalemic, 20 healthy) were examined. Electrocardiographic patterns of hypokalemia were evident in 46 p.c. of all patients with serum potassium less than 3,5 mval/l. Patients without cardiac disease showed signs of hypokalemia in the ECG in 68 p.c., those cases with extremly low serum potassium (less than 2,5 mval/l) in 81 p.c. In patients without cardiac disease a good correlation could be observed between ST depression and T wave inversion on one side and serum potassium level below 3,5 mval/l on the other side. The T/U ratio was found to be below unity in only 9 p.c. in mild hypokalemia, but in 82 p.c. in severe hypokalemia. ECG pattern of hyperkalemia could be found in 29 p.c. of all patients with serum potassium levels greater than 5,1 mval/l. These signs were evident in patients without cardiac disease in 29 p.c. in mild hyperkalemia, but in 75 p.c. in severe hyperkalemia. Patients suffering from cardiac disease, however showed the correspondive ECG changes of hyperkalemia only in 5 p.c. There is a good correlation between the P, and T-wave-amplitude and the serum potassium level greater than 5,1 mval/l. According to our findings it can be stated, that the ECG changes in patients with cardiac disease tend to hide the correspondive changes of potassium disorder.

摘要

对163例患者(95例低钾血症、48例高钾血症、20例健康者)进行了检查。血清钾低于3.5毫当量/升的所有患者中,46%有低钾血症的心电图表现。无心脏病的患者中,68%的心电图有低钾血症迹象,血清钾极低(低于2.5毫当量/升)的患者中,81%有此迹象。在无心脏病的患者中,一侧的ST段压低和T波倒置与另一侧血清钾水平低于3.5毫当量/升之间存在良好的相关性。轻度低钾血症患者中,仅9%的T/U比值低于1,但重度低钾血症患者中,82%的T/U比值低于1。血清钾水平高于5.1毫当量/升的所有患者中,29%有高钾血症的心电图表现。无心脏病的患者中,轻度高钾血症时29%有这些表现,但重度高钾血症时75%有这些表现。然而,患有心脏病的患者中,只有5%出现高钾血症相应的心电图变化。P波和T波振幅与血清钾水平高于5.1毫当量/升之间存在良好的相关性。根据我们的研究结果可以说,心脏病患者的心电图变化往往会掩盖钾紊乱的相应变化。

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