急性心肌梗死早期血钾浓度与冠状动脉造影相关罪犯血管及室性心律失常的关系

Relation between serum potassium solubility of early acute myocardial infarction and culprit coronary artery, ventricular arrhythmias

目的 探讨急性心肌梗死患者早期血钾浓度与冠状动脉造影相关罪犯血管及室性心律失常的关系.方法 选择136例符合“急性心肌梗死诊断标准”,且发病时间＜12 h的患者.入院后立即采静脉血3ml,测血钾浓度,做18导联心电图.患者均同意做急诊介入治疗,给予冠状动脉造影,确定急性心肌梗死的罪犯血管.观察急性心肌梗死患者早期血钾浓度与冠状动脉造影确定罪犯血管及室性心律失常的关系,并进行统计学分析.结果 急性心肌梗死罪犯血管为左前降支的血钾浓度最低,左回旋支血钾浓度最高,右冠状动脉的血钾浓度位于左前降支及左回旋支之间.左前降支病变与左回旋支病变血钾浓度对比差异有统计学意义（P＜0.01）.右冠状动脉病变与左回旋支病变血钾浓度对比差异有统计学意义（P＜0.05）.急性心肌梗死低血钾组与正常血钾组室性心律失常发生率对比差异有统计学意义（P＜0.01）.结论 急性心肌梗死患者,罪犯血管是左前降支的发病早期最容易合并低血钾,预后普遍较差.急性心肌梗死早期合并低血钾易发生室性心律失常.

Objective To discuss the relation between serum potassium solubility of early acute myocardial infarction and culprit coronay artery and ventricular arrhythmias.Methods A total of 136 patients conformed with acute myocardial infarction were enrolled.The onset time was all less than 12 h.After admission,concentration of serum potassium was measured,18 leads ECG were undergone.After that,these patients underwent emergency interventional therapy.The relationship between the level of serum potassium and the culprit artery in acute myocardial infarction and ventricular arrhythmias were analyzed.Results In acute myocardial infarction patients,the concentration of serum potassium was lowest in patients with anterior descending branch as culprit artery.The left circumflex artery for criminal vessel blood potassium concentration was highest,blood potassium concentration in right coronary artery lesion was in the middle of them.The concentration of potassium has significant difference between anterior descending artery and left circumflex artery blood （P＜0.01）,the difference all existed between right coronary artery and left circumflex artery blood （P＜0.05）.In acute myocardial infarction hypokalemia group and normal potassium group,the incidence of ventricular arrhythnias was very significant （P＜0.01）.Conclusion In patients with acute myocardial infarction,the culprit artery with anterior descending branch is the most easily with low blood potassium,the prognosis is generally poor.