VENTRICULAR-TACHYCARDIA IN ACUTE MYOCARDIAL-INFARCTION - THE ROLE OF HYPOPHOSPHATEMIA
VENTRICULAR-TACHYCARDIA IN ACUTE MYOCARDIAL-INFARCTION - THE ROLE OF HYPOPHOSPHATEMIA
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DOI：
10.1097/00007611-199401000-00014
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发表时间：
1994-01-01
影响因子：
1.1
通讯作者：
WHITTIER, F
中科院分区：
文献类型：
--
作者：
OGNIBENE, A;CINIGLIO, R;WHITTIER, F
某些电解质的血清浓度与心肌梗死室性心律失常的发病机制之间的关系一直是经常回顾的主题。低磷血症在急性心肌梗死患者心律失常发病机制中的作用尚未得到充分研究。在我们的研究组中，325例连续入住社区医院冠状动脉护理病房的患者中，有111例被证实患有心肌梗死。在最初的24小时内持续监测患者的室性心律失常，并检查心律失常的心电图记录。从入院血液样本中，测量电解质包括血清磷酸盐、钙、碳酸氢盐、钾和镁。研究室性心动过速与血清电解质异常（包括镁、钾、磷酸盐、钙和碳酸氢盐）之间的关系。低磷酸盐（低于2.6 mg/dL）是心肌梗死组室性心动过速的重要预测因子。在确认心肌梗死之前的325例患者中，低碳酸氢盐和低磷酸盐是住院前24小时室性心动过速的重要预测因素。虽然酸中毒的处理在住院早期就被考虑，但磷酸盐替代疗法通常不被考虑。我们建议进一步研究替代疗法对低磷血症胸痛患者的有效性，以降低室性心动过速的风险。
The relationship between serum concentration of certain electrolytes and the pathogenesis of ventricular arrhythmia in myocardial infarction has been the subject of frequent review. The role of hypophosphatemia in the pathogenesis of arrhythmia in patients with acute myocardial infarction has not been as well studied. In our study group of 325 consecutive patients admitted to the coronary care unit of a community hospital, 111 were confirmed to have had a myocardial infarction. Patients were continuously monitored for ventricular arrhythmia during the first 24 hours, and the electrocardiographic records were reviewed for documentation of arrhythmia. From an admission blood sample, measurement of electrolytes included serum phosphate, calcium, bicarbonate, potassium, and magnesium. Associations between ventricular tachycardia and serum electrolyte abnormalities including magnesium, potassium, phosphate, calcium, and bicarbonate were studied. Low phosphate (less than 2.6 mg/dL) was a significant predictor of ventricular tachycardia in the myocardial infarction group. In the entire group of 325 patients prior to the confirmation of myocardial infarction, both low bicarbonate and low phosphate were significant predictors of ventricular tachycardia during the first 24 hours of hospitalization. Although management of acidosis is considered early in the hospital course, phosphate replacement therapy is usually not as often considered. We recommend further study on the effectiveness of replacement therapy in hypophosphatemic patients with chest pain to reduce the risk of ventricular tachycardia.