心电图对高钾血症的诊断价值

Clinical value of electrocardiogram changes on the diagnosis of hyperkalemia

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5．5mmol／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，呈帐篷状；血清钾大于6．7mmol／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10．0mmol／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。

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 are 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 arrhyth, mia;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 electrocardiogram will be occurred, when mixed other electrolyte unbalance. Pseudo-hyperkalemia can be distinguished accurately and conveniently by using this method.