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作者报道了730例心衰病人住院过程中6例(0.8%)9次发生致命性高血钾症(平均血钾水平为7.2±0.5mEq/L).6例均因心衰加重入院,心功均为Ⅳ级,5例被纠正.ECG显示宽大畸形QRS波及ST-T特征性改变.钾按维持量补充.分析发现,突发高血钾症发生前,都有血液动力学紊乱或/和因利尿剂用量过大造成低血钾而口服大量钾现象.对于大部份病例,一个可能原因是因严重心衰加重引起灌注量降低及代谢性酸中毒,肾小球滤过率降低,钾排除减少引起高血钾症.本组据洋地黄血清水平排除洋地黄中毒可能.心衰患者高血钾发生率目前还不清楚。
The authors reported fatal hyperkalemia (mean serum potassium level 7.2 ± 0.5 mEq / L) in 6 of 9 (0.8%) hospitalized patients during 730 hospitalizations for heart failure, 6 of whom were admitted to hospital with heart failure Power were grade Ⅳ, 5 were corrected .ECG showed large deformity QRS wave and ST-T characteristic changes.K supplement was maintained by the amount of analysis found that sudden onset of hyperkalemia, there are hemodynamic disorders or / And due to excessive use of diuretics caused by hypokalemia and oral potassium in large quantities for most cases, a possible reason is due to severe heart failure caused by reduced perfusion and metabolic acidosis, decreased glomerular filtration rate, Reduced potassium excretion caused by hyperkalemia .The group according to digitalis serum levels of digitalis poisoning may be ruled out.The incidence of hyperkalemia in patients with heart failure is not yet clear.