急性心肌梗死患住院期间平均血钾水平和预后之间的关系.docxVIP

急性心肌梗死患者住院期间平均血钾水平和预后之间的关系 程澜 【摘要】目的：探讨急性心肌梗死患者住院期间平均血钾水平与3年后死亡率之间的关系，从而为这类患者应维持的最佳血钾水平提供临床依据。方法：武汉亚洲心脏病医院2012年01月至2013年01月进入急诊系统的1190例急性心肌梗死患者纳入本研究，根据其平均血钾浓度分为五组：＜3.5，3.5-4.0，4.0-4.5，4.5-5.0，＞5.0mmol/L。用Cox回归分析比较3年后死亡率。结果：患者平均随访时间3.12±1.24年。血钾3.5-4.0mmol/L组死亡率最低。结论：目前再灌注治疗和以循证医学为基础的药物治疗已常规应用，可能现代急性心肌梗死患者的理想血钾水平是3.5-4.0mmol/L之间。 【关键词】急性心肌梗死，血钾，死亡率 Relation of Serum Potassium Level to Outcomes in Patients With Acute Myocardial Infarction Cheng Lan: Wuhan Asia Heart Hospital, Wuhan 430022 Email: 471907791@ 【Abstract】 Objectives: This study is to explore the relation of the average serum potassium levels measured throughout the hospitalization to 3-year mortality in patients with acute myocardial infarction(AMI). Therefore, it provides the clinical basic on the ideal serum potassium level in patients with AMI. Methods: A total of 1190 patients who were admitted to the emergency department of Wuhan Asia Heart Hospital from January 2012 to January 2013 with a diagnosis of AMI were evaluated retrospectively. Patients were categorized into 5 groups according to the average serum potassium levels: ＜3.5，3.5-4.0，4.0-4.5，4.5-5.0，＞5.0mmol/L. Cox proportional regression analysis was used to compare 3-year mortality by categories of mean serum potassium level. Results: The patients were followed up for a mean period of 3.12±1.24 years. The mortality was lowest in the group of patients with potassium levels of 3.5 to ＜4.0 mmol/L. Conclusions: Modern AMI management strategies, incorporating reperfusion therapy and evidence-based medications, are in routine use. Currently, it is possible that the ideal serum potassium level in patients with AMI is from 3.5 to ＜4.0 mmol/L. 【Key Word】acute myocardial infarction (AMI), serum potassium level, mortality 血钾是心脏功能的重要影响因素。通常，低钾血症被定义为＜3.5mmol/L。临床医生常常在急性心肌梗死的患者中观察到低钾血症 ADDIN KYMRREF{0BAAAC45-5C17-4437-8A01-817E93D36810}8[1]，且低钾血症和恶性心律失常、猝死密切相关 ADDIN KYMRREF{0BAAAC45-5C17-4437-8A01-817E93D36810}9[2]。根据既往的研究，目前临床指南推荐在急性心肌梗死的患者中血钾水平要保持在4.0mmol/