The Influence of Stratified Serum Potassium Levels on Intervals of PR, QRS, QT, and QTc on Electrocardiogram in Maintenance Hemodialysis Patients

血液透析病人成層血液鉀離子濃度對心電圖上PR, QRS, QT, QTc的區間長度影響

黃銘傳(Ming-Chung Huang) ； 陳靖博(Jin-Bor Chen) ； 廖上智(Shang-Chih Liao)

《Acta Nephrologica》 21卷3期 (2007/10) Pp. 206-210

摘要

背景：血液透析病人其血液鉀離子濃度對心臟節律的影響是非常重要的。本研究目的是比較長期規則血液透析病人，成層血液鉀離子變化對於心電圖上PR, QRS, QT, QTc區間的影響。
方法：我們收集了141位血液透析病人與42位健康成人來做比較。每位受檢者接受12導程心電圖來取得PR, QRS, QT, QTc的區間長短。從每位受檢者身上抽取週邊血來做血液分析跟生化檢查。依照血液鉀離子濃度分組來計算各組的PR, QRS, QT, QTc區間長短。
結果：根據血液透析病人的血液鉀離子濃度(≦4.8,4.9-6.0，≧6.1mEq/L)將血液透析病人區分成三組。群組一：共39位病人，血中平均鉀離子濃度4.36mEq/L。群組二：共72位病人，血中平均鉀離子濃度5.33mEq/L。群組三：共30位病人，血中平均鉀離子濃度6.82mEq/L。這三組病人其餘的血液跟生化檢查並沒有顯著的差別。群組一的病人較其他兩組病人有較長的血液透析時間（95個月VS79個月VS52個月）。這三組血液透析病人比對照組的人有較長的QTc區間(427.62±30.19ms, p=0.002; 423.40±23.87ms, p=0.004; 429.07±33.49ms, p=0.002; vs 406.93±33.17ms)。至於PR, QRs, QT區間在血液透析病人跟對照組間並沒有顯著差異。
結論：血液透析病人較健康人有較長的QTc區間。但是QTc區間長短不會跟著血液鉀離子濃度上升而等比例上升。

關鍵字

鉀離子 ； 心電圖 ； 血液透析 ； QTc區間

並列摘要

Background: The impact of serum potassium (K) levels on cardiac rhythm is important in hemodialysis (HD) patients. The aim of this study was to compare the intervals of PR, QRS, QT, and QTc on the electrocardiogram in maintenance HD patients with stratified serum K levels.
Methods: One hundred and forty-one HD patients and 42 healthy subjects were enrolled. Peripheral blood for hemogram and biochemistry examinations was obtained from those patients. The intervals of PR, QRS, QT, and QTc from 12-lead electrocardiogram were calculated according to stratified serum K levels.
Results: The HD patients were divided into three groups with stratified serum K levels (Group 1,≤4.8; Group 2, 4.9-6.0; and group 3,≥6.1 mEq/L). Group 1: 39 patients with mean serum K level 4.36 mEq/L, Group 2: 72 patients, mean serum K level 5.33 mEq/L, and Group 3: 30 patients, mean serum K level 6.82 mEq/L. The variables of biochemistry and hemogram were not significantly different among the three groups. Group 1 patients had longer HD duration than the other two groups' of patients (95 months vs 79 months vs 52 months). Subjects in the three groups had longer QTc intervals than controls (427.62±30.19 ms, P=0.002; 423.40±23.87 ms, P=0.004; 429.07±33.49 ms, P=0.002; vs. 406.93±33.17 ms). The intervals of PR, QRS, and QT were not significantly different between HD and control subjects.
Conclusion: HD patients had longer QTc intervals than healthy subjects. The QTc intervals were not proportional prolongation with stratified serum K levels.

並列關鍵字

potassium ； electrocardiogram ； hemodialysis ； QTc interval