慢性肾病高钾血症者心电图T波改变特征

Clinical analysis of Hyperkalemia-related ECG T-wave changes in patients with Chronic Kidney Disease

目的探索慢性肾脏病(Chronic kidney disease,CKD)高钾血症相关心电图T波改变特征。方法收集2017年1月～2018年1月期间于我院就诊的CKD高钾血症患者为观察组,选取同期非CKD高钾血症患者为对照组,比较两组患者T波形态、振幅改变特点和导联分布特点。结果 CKD及非CKD高钾血症患者心电图"帐篷状"T波发生率分别为90.5%、93.2%。观察组非典型"帐篷状"T波发生率61%,与对照组34.1%比较,差异有统计学意义(p<0.05);观察组患者典型"帐篷状"T波发生在前壁的约96.3%,与对照组85.2%比较,差异无统计学意义(p>0.05);观察组患者非典型"帐篷状"T波发生在侧壁的约74.2%,与对照组28.6%比较,差异有统计学意义(p<0.05)。结论波峰变尖、基底部变窄或双支对称的T波改变是CKD高钾血症相关心电图改变的一个良好指标;CKD高钾血症患者心电图T波改变主要表现为非典型"帐篷状"T波,且主要分布在侧壁导联。

Objective To determine the characteristic of hyperkalemia-related ECG T wave changes in patients with chronic kidney disease（CKD）. Methods We selected hyperkalemia patients with CKD as research objects who had been treated in our hospital from January 2017 to January 2018. At the same time the non-CKD patients with hyperkalemia were enrolled as control group. T-wave changes of morphologic, amplitude and leads were analysis between the two groups. Results Overall rates of hyperkalemia-related ECG changes in patients with CKD or without CKD were higher, accounted for 90.5%, 93.2 % respectively. Between CKD and non-CKD hyperkalemia patients,rates of atypical ＂tenting＂ T-waves 61% vs 34.1% and atypical ＂tenting＂ T-waves in lateral leads 74.2% vs 28.6%were significantly different（p〈0.05）. Between CKD and non-CKD hyperkalemia patients, rates of typical ＂tenting＂ T-waves in anterior leads 96.3% vs 85.2% was not vary significantly different（p〉0.05）. Conclusion T-waves changes with peaked, shortened/symmetrical alteration is hyperkalemia-related ECG changes, which serve as a good indicators of hyperkalemia in CKD patients. For the hyperkalemia patients with CKD, T-waves changes mainly showed atypical ＂tenting＂ in lateral leads.