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JAHA:心衰患者血钾水平升高的发生、危险因素及临床结局!

2018-05-22 xing.T MedSci原创

由此可见,在10例HF患者中有4例出现高钾血症,许多患者出现反复高血钾发作。高钾血症风险与肾功能下降程度和螺内酯的使用密切相关。高钾血症与HF患者严重的临床结局和死亡有关。

在现实世界中,心力衰竭患者的高钾血症负担的数据是十分有限的。近日,心血管疾病领域权威杂志JAHA上针对这一问题发表了一篇研究文章。

在2000至2012年期间,丹麦北部HF诊断的人群队列中评估了原发性或医院护理中出现的高钾血症(第一血液检测钾水平>5mmol/L)的发生率。研究人员比较了伴有和不伴有高钾血症的HF患者的危险因素和临床结局。

在31例HF患者中,39%的患者出现了高钾血症(平均随访时间为2.2年)。经历第二、第三或第四事件的风险分别为43%、54%和60%。在患有3A、3B、4或5期肾功能不全的HF患者在第一年分别有26%、35%、44%和48%的患者出现了高钾血症。重要的高钾血症危险因素包括慢性肾脏病(患病率比为1.46,95%可信区间[CI]为1.43-1.49)、糖尿病(患病率比为1.38,95%CI为1.32-1.45)以及螺内酯使用率(患病率比为1.48,95%CI为1.42-1.54)。在高钾血症的HF患者中,53%在高血钾事件前6个月均有急性住院治疗的经历,高钾血症后6个月增加至74%(之前与之后的风险比为1.41,95%CI为1.38-1.44)。与匹配的没有高钾血症的HF患者相比,高钾血症患者在急性住院治疗方面6个月调整后的风险比要高2.75倍(95%CI为2.65-2.85),而死亡要高3.39倍(95%CI为3.19-3.61)。

由此可见,在10例HF患者中有4例出现高钾血症,许多患者出现反复高血钾发作。高钾血症风险与肾功能下降程度和螺内酯的使用密切相关。高钾血症与HF患者严重的临床结局和死亡有关。

原始出处:

Reimar Wernich Thomsen,et al. Elevated Potassium Levels in Patients With Congestive Heart Failure: Occurrence, Risk Factors, and Clinical Outcomes A Danish Population‐Based Cohort Study, JAHA.2018. https://doi.org/10.1161/JAHA.118.008912

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    2018-05-24 zhaohui6731
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    2018-05-23 张新亮1853311252142e2fm

    好文献学习了

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1812616, encodeId=db461812616a5, content=<a href='/topic/show?id=dbf6899e8cf' target=_blank style='color:#2F92EE;'>#血钾水平#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89978, encryptionId=dbf6899e8cf, topicName=血钾水平)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Thu Jun 07 11:48:00 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1843166, encodeId=b807184316691, content=<a href='/topic/show?id=3d052296e4e' target=_blank style='color:#2F92EE;'>#临床结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22967, encryptionId=3d052296e4e, topicName=临床结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7fbd46, createdName=mei531, createdTime=Mon Jun 18 07:48:00 CST 2018, time=2018-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267825, encodeId=8042126e82554, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Thu May 24 13:48:00 CST 2018, time=2018-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1373410, encodeId=60e013e341085, content=<a href='/topic/show?id=2fd051939ab' target=_blank style='color:#2F92EE;'>#心衰患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51939, encryptionId=2fd051939ab, topicName=心衰患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=467c360, createdName=yuanming7, createdTime=Thu May 24 13:48:00 CST 2018, time=2018-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=317760, encodeId=a48231e76012, content=好文献学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a62240667, createdName=张新亮1853311252142e2fm, createdTime=Wed May 23 07:20:18 CST 2018, time=2018-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=317730, encodeId=b8b231e73052, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Wed May 23 06:48:23 CST 2018, time=2018-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=317650, encodeId=33c931e6504f, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Tue May 22 23:24:46 CST 2018, time=2018-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=317639, encodeId=897531e63937, content=不错的文章值得学习到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04f22055142, createdName=131****2916, createdTime=Tue May 22 23:22:55 CST 2018, time=2018-05-22, status=1, ipAttribution=)]
    2018-05-23 1209e435m98(暂无昵称)

    学习了.谢谢分享

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1812616, encodeId=db461812616a5, content=<a href='/topic/show?id=dbf6899e8cf' target=_blank style='color:#2F92EE;'>#血钾水平#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89978, encryptionId=dbf6899e8cf, topicName=血钾水平)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Thu Jun 07 11:48:00 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1843166, encodeId=b807184316691, content=<a href='/topic/show?id=3d052296e4e' target=_blank style='color:#2F92EE;'>#临床结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22967, encryptionId=3d052296e4e, topicName=临床结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7fbd46, createdName=mei531, createdTime=Mon Jun 18 07:48:00 CST 2018, time=2018-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267825, encodeId=8042126e82554, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Thu May 24 13:48:00 CST 2018, time=2018-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1373410, encodeId=60e013e341085, content=<a href='/topic/show?id=2fd051939ab' target=_blank style='color:#2F92EE;'>#心衰患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51939, encryptionId=2fd051939ab, topicName=心衰患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=467c360, createdName=yuanming7, createdTime=Thu May 24 13:48:00 CST 2018, time=2018-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=317760, encodeId=a48231e76012, content=好文献学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a62240667, createdName=张新亮1853311252142e2fm, createdTime=Wed May 23 07:20:18 CST 2018, time=2018-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=317730, encodeId=b8b231e73052, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Wed May 23 06:48:23 CST 2018, time=2018-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=317650, encodeId=33c931e6504f, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Tue May 22 23:24:46 CST 2018, time=2018-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=317639, encodeId=897531e63937, content=不错的文章值得学习到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04f22055142, createdName=131****2916, createdTime=Tue May 22 23:22:55 CST 2018, time=2018-05-22, status=1, ipAttribution=)]
    2018-05-22 天地飞扬

    了解一下.谢谢分享!

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1812616, encodeId=db461812616a5, content=<a href='/topic/show?id=dbf6899e8cf' target=_blank style='color:#2F92EE;'>#血钾水平#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89978, encryptionId=dbf6899e8cf, topicName=血钾水平)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Thu Jun 07 11:48:00 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1843166, encodeId=b807184316691, content=<a href='/topic/show?id=3d052296e4e' target=_blank style='color:#2F92EE;'>#临床结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22967, encryptionId=3d052296e4e, topicName=临床结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7fbd46, createdName=mei531, createdTime=Mon Jun 18 07:48:00 CST 2018, time=2018-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267825, encodeId=8042126e82554, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Thu May 24 13:48:00 CST 2018, time=2018-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1373410, encodeId=60e013e341085, content=<a href='/topic/show?id=2fd051939ab' target=_blank style='color:#2F92EE;'>#心衰患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51939, encryptionId=2fd051939ab, topicName=心衰患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=467c360, createdName=yuanming7, createdTime=Thu May 24 13:48:00 CST 2018, time=2018-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=317760, encodeId=a48231e76012, content=好文献学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a62240667, createdName=张新亮1853311252142e2fm, createdTime=Wed May 23 07:20:18 CST 2018, time=2018-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=317730, encodeId=b8b231e73052, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Wed May 23 06:48:23 CST 2018, time=2018-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=317650, encodeId=33c931e6504f, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Tue May 22 23:24:46 CST 2018, time=2018-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=317639, encodeId=897531e63937, content=不错的文章值得学习到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04f22055142, createdName=131****2916, createdTime=Tue May 22 23:22:55 CST 2018, time=2018-05-22, status=1, ipAttribution=)]
    2018-05-22 131****2916

    不错的文章值得学习到了

    0

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