Serum Potassium and the Electrocardiogram in Hypokalemia
Serum Potassium and the Electrocardiogram in Hypokalemia
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低钾血症时的血清钾和心电图
DOI：
10.1161/01.cir.21.4.505
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发表时间：
1960
期刊：
影响因子：
37.8
通讯作者：
H. Burchell
中科院分区：
文献类型：
--
作者：
W. Weaver;H. Burchell
在低钾血症水平下，心电图和血清钾水平之间可以建立明确的相关性。在马约诊所对130名临床状态相对稳定的低钾血症患者进行了一项研究。观察了低钾血症时Q-T间期、P-R间期、房性心律、P波、T/R值、T波和U波轮廓的变化，以及T-U波复合波、电复极现象和钾代谢之间的关系。由于通过仔细选择患者排除了药物、某些电解质紊乱、心率变化、传导缺陷和心肌缺血等修饰因素，因此仅研究了酸碱失衡、钠钾比值和高血压对心电图的影响。酸碱失衡和高血压常常模拟或掩盖低钾血症的心电图证据。低钾血症的心电图标准包括以下体征的各种组合：（1）II或V3导联T/U值为1或更小，（2）II导联U波振幅大于0.5 mm或V3导联U波振幅大于1 mm，（3）II或V1、V2和V3导联S-T压低0.5 mm或更大。必须记住，正常的心电图并不排除低钾血症，符合既定标准的心电图并不一定表明低钾血症，除非所讨论的因素已被消除或最小化。
A definite correlation can be established between the electrocardiogram and the serum potassium level at hypokalemic levels. A study was made at the Mayo Clinic of 130 hypokalemic patients with relatively stable clinical states. Variations in Q-T intervals, P-R intervals, atrial rhythm, P waves, T/R values, and T-wave and U-wave contour in hypokalemia were noted as were the relationships between the T-U complex, electrical repolarization phenomena and potassium metabolism. Since modifying factors such as drugs, certain electrolyte disturbances, variations in cardiac rate, conduction defects, and myocardial ischemia were eliminated by careful selection of patients, only the influence of acid-base imbalance, sodium-potassium ratio, and hypertension on the electrocardiogram was studied. Acid-base imbalance and hypertension often simulated or obscured electrocardiographic evidence of hypokalemia. Electrocardiographic criteria of hypokalemia include various combinations of the following signs: (1) T/U value of 1 or less in lead II or V3, (2) U-wave amplitudes of greater than 0.5 mm. in lead II or greater than 1 mm. in V3, and (3) S-T depression of 0.5 mm. or more in lead II or leads V1, V2, and V3. It must be remembered that a normal electrocardiogram does not exclude hypokalemia and that an electrocardiogram which fulfills the established criteria does not necessarily indicate hypokalemia unless the factors discussed have been eliminated or minimized.