Electrocardiogram findings of patients with serum potassium levels of nearly 10.0 mmol/L: a report of two cases.
Electrocardiogram findings of patients with serum potassium levels of nearly 10.0 mmol/L: a report of two cases.
复制标题
血钾近10.0 mmol/L患者心电图表现：附2例报告
DOI：
10.1002/ams2.45
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发表时间：
2014
影响因子：
1.6
通讯作者：
Kinoshita Y
中科院分区：
文献类型：
--
作者：
Kotera A;Irie H;Iwashita S;Taniguchi J;Kasaoka S;Sagishima K ;Kamohara H;Kinoshita Y
病例1，一名63岁女性因肌肉无力入院。她在血液透析中有高血压、糖尿病和慢性肾功能衰竭。她在服用一种β-受体阻滞剂。她的脉搏是每分钟42 。心律失常；血钾9.8 /L；心电图显示QRS波群增宽(0.256 S)。在病例2中，一名59岁男子因肌肉无力入院。他有高血压和慢性肾功能衰竭，正在服用肾素-血管紧张素-醛固酮系统抑制剂。他的脉搏是每分钟42 。结果：慢性肾功能衰竭、糖尿病或影响肾外钾稳态的药物均可产生对高钾血症的耐受性。结论慢性肾功能衰竭、糖尿病或影响肾外钾稳态的药物均可产生对高钾血症的耐受性。结论慢性肾功能衰竭、糖尿病或影响肾外钾稳态的药物均可使患者对高钾血症产生耐受性。结论慢性肾功能衰竭、糖尿病或影响肾外钾稳态的药物均可使患者对高钾血症产生耐受性。结论慢性肾功能衰竭、糖尿病及影响肾外钾稳态的药物治疗均可使患者对高钾血症产生耐受性。结论慢性肾功能衰竭、糖尿病及影响肾外钾稳态的药物治疗均可使患者对高钾血症产生耐受性。这种耐受性可能有助于预防危及生命的心律失常，尽管血钾水平处于致命水平。
CasesIn Case 1, a 63‐year‐old woman was admitted with muscular weakness. She had hypertension, diabetes mellitus, and chronic renal failure on hemodialysis. She was taking a beta‐blocker. Her pulse rate was 42 b.p.m. (irregular rhythm); serum potassium level was 9.8 mmol/L; electrocardiogram revealed widening of the QRS complex (0.256 s). In Case 2, a 59‐year‐old man was admitted with muscular weakness. He had hypertension and chronic renal failure, and was taking a renin–angiotensin–aldosterone system inhibitor. His pulse rate was 42 b.p.m. (irregular rhythm); serum potassium level was 10.1 mmol/L; electrocardiogram revealed widening of the QRS complex (0.180 s).OutcomeLife‐threatening arrhythmia did not occur, and patients survived under appropriate treatment.ConclusionChronic renal failure, diabetes mellitus, or medications affecting extrarenal potassium homeostasis can produce a tolerance to hyperkalemia. This tolerance may help prevent life‐threatening arrhythmia despite fatal levels of serum potassium.