心电图诊断高钾血症的临床价值

Clinical value of electrocardiogram in diagnosis of hyperkalemia

目的探析心电图诊断高钾血症的效果。方法选取南阳市第一人民医院2020年5月至2022年1月收治的疑似高钾血症患者共90例作为研究对象,所有患者均行心电图检查、实验室检验,以实验室检验结果作为金标准,观察心电图检查的诊断效能,分析心电图异常与血清钾浓度的相关性,并对高钾血症和非高钾血症患者心电图病因诊断符合情况进行对比。结果心电图诊断高钾血症的准确率为86%、特异度为85%、敏感度为86%、阳性预测值为91%、阴性预测值为78%,而且血清钾浓度与心电图异常发生率呈正相关(P<0.05)。对高钾血症与非高钾血症患者的病因进行心电图诊断发现,尿毒症、糖尿病、脑出血患者的心电图诊断符合率高于非高钾血症,差异有统计学意义(P<0.05)。结论心电图诊断高钾血症的准确度、特异度、敏感度、阳性预测值、阴性预测值均比较高,其血清钾浓度越高,心电图的异常情况越明显,临床应用价值高,建议推广应用。

Objective To investigate the value of electrocardiogram(ECG)in the diagnosis of hyper-kalemia.Methods Ninety patients with suspected hyperkalemia admitted to our hospital between May 2020 and January 2022 were included as the subjects in the study.All patients underwent ECG and laboratory investiga-tions.Using the laboratory findings as the gold standard,the diagnostic efficacy of ECG was determined,the correlation between abnormal ECG and serum potassium concentration was analyzed,and the coincidence of etiology diagnosis with ECG in patients with hyperkalemia and non-hyperkalemia was compared.Results The accuracy,specificity,sensitivity,positive predictive value and negative predictive value of ECG in the diagnosis of hyperkalemia were 86%,85%,86%,91%and 78%,respectively.There was a positive corre-lation between serum potassium concentration and the incidence of ECG abnormalities(P<0.05).The ECG dia-gnosis of the etiology of hyperkalemia and non-hyperkalemia patients showed that the ECG diagnosis coincidence rate of uremia,diabetes and cerebral hemorrhage patients was higher than that of non-hyperkalemia patients,and the difference was statistically significant(P<0.05).Conclusion The accuracy,specificity,sensitivity,positive predictive value,and negative predictive value of ECG in the diagnosis of hyperkalemia are relatively high.Hig-her level of serum potassium concentration is associated with more obvious abnormality of ECG,and therefore is clinically valuable and warrants widespread use.