Trojak Benoit, Astruc Karine, Pinoit Jean-Michel, Chauvet-Gelinier Jean-Christophe, Ponavoy Eddy, Bonin Bernard, Gisselmann André
Department of Psychiatry and Addiction, University Hospital of Dijon, France.
Psychiatry Res. 2009 Oct 30;169(3):257-60. doi: 10.1016/j.psychres.2008.06.031. Epub 2009 Sep 10.
Several studies have revealed a relatively high frequency of hypokalemia in the general psychiatric population. This may be explained by adrenergic stimulation observed in the acute phase of psychiatric disorders. Little is known about the effects of hypokalemia on cardiac repolarisation in these circumstances. The current study was designed to determine if the hypokalemia observed among patients with acute psychiatric disorders can cause significant QT interval prolongation, and thus increase the risk of ventricular arrhythmia. Electrocardiograms were obtained in 282 non-selected patients admitted to a psychiatric unit. Heart-rate adjusted QT intervals (QTc) were compared to serum potassium levels and to other risk factors for QT prolongation (bradycardia, age, gender, and administration of antipsychotics). Hypokalemia, diagnosed in more than 11% of the patients, was associated with a significantly longer QTc interval (means 423.5+/-40 ms vs 408.5+/-31 ms), as was female sex. Multiple linear regression analysis on the studied risk factors revealed that only hypokalemia and female sex were independently associated with lengthening of the QT interval. According to our results, hypokalemia seems to be one of the most important risk factors for QT prolongation. We therefore strongly recommend that psychiatric patients should be screened for hypokalemia on admission.
多项研究表明，普通精神科患者中低钾血症的发生率相对较高。这可能是由于在精神疾病急性期观察到的肾上腺素能刺激所致。在这些情况下，低钾血症对心脏复极化的影响知之甚少。本研究旨在确定急性精神疾病患者中观察到的低钾血症是否会导致显著的QT间期延长，从而增加室性心律失常的风险。对入住精神科病房的282例未经过筛选的患者进行了心电图检查。将心率校正的QT间期（QTc）与血清钾水平以及其他QT延长风险因素（心动过缓、年龄、性别和抗精神病药物的使用）进行了比较。超过11%的患者被诊断为低钾血症，其QTc间期显著延长（平均423.5±40毫秒对400.5±31毫秒），女性也是如此。对所研究的风险因素进行多元线性回归分析发现，只有低钾血症和女性与QT间期延长独立相关。根据我们的结果，低钾血症似乎是QT延长的最重要风险因素之一。因此，我们强烈建议对精神科患者入院时进行低钾血症筛查。
