【摘要】：目的:回顧性分析近6年我院內(nèi)分泌科住院患者低鉀血癥的發(fā)病原因,入院時(shí)的臨床表現(xiàn)、治療及轉(zhuǎn)歸,進(jìn)而了解內(nèi)分泌住院患者低鉀血癥的臨床特點(diǎn),以提高低鉀血癥的病因診斷及治療水平。方法:利用病案查詢系統(tǒng)回顧性分析2010.06.01-2016.05.31我院內(nèi)分泌科收治的明確診斷為低鉀血癥且病例資料完整者482例,剔除偶然性及一過性因素,收集記錄每位患者的臨床資料,包括性別、年齡、原發(fā)病、臨床表現(xiàn)、輔助檢查、低鉀血癥的病因及各種原因所占比例,用SPSS22.0軟件進(jìn)行數(shù)據(jù)分析,所有連續(xù)計(jì)量變量資料以均數(shù)±標(biāo)準(zhǔn)差(x±s)表示,組間比較采用方差分析(F);計(jì)數(shù)資料以百分比(%)表示,組間比較采用卡方檢驗(yàn)(χ2)。結(jié)果:我院內(nèi)分泌科2010.06.01-2016.05.31共收治患者12167人次,其中低鉀血癥患者482例(占3.96%)。統(tǒng)計(jì)分析結(jié)果顯示:①近6年所收治的低鉀血癥患者年齡12-93歲,平均年齡53.01±17.65歲,其中40歲以下119例(24.69%),40-60歲共181例(37.55%),60歲以上共182例(37.76%),主要以40歲以上中老年患者為主。②其中男性234例(48.55%),女性248例(51.45%),男女比例約為0.94:1。③根據(jù)低鉀血癥的程度劃分,輕度低鉀血癥(血鉀3.0-3.5mmol/L,不包含3.5mmol/L)279例(57.88%),其中主要因糖尿病所致者169例,占輕度低血鉀的60.57%,其次為消化道原因及利尿劑所致,中度低鉀血癥(血鉀2.5-3.0mmol/L,不包含3.0mmol/L)122例(25.31%),重度低鉀血癥(血鉀2.5mmol/L)81例(16.81%),以輕度低鉀血癥患者為主。④內(nèi)分泌相關(guān)性低鉀病因中血鉀程度分布,糖尿病患者輕度低鉀169例(75.45%),中度低鉀46例(20.54%),重度低鉀9例(4.02%),PA患者輕度低鉀10例(25.64%),中度低鉀19例(48.72%),重度低鉀10例(25.64%),THPP患者中,輕度低鉀4例(15.38%),中度低鉀6例(23.08%),重度低鉀16例(61.54%);CS患者輕、中、重低鉀分別為2例、6例、4例。⑤非內(nèi)分泌相關(guān)性低鉀病因中血鉀程度分布,消化道因素中,輕度低鉀45例(65.22%),中度低鉀17例(24.64%),重度低鉀7例(10.14%);藥物因素中,輕度低鉀40例(60.61%),中度低鉀17例(25.75%),重度低鉀9例(13.64%);低鉀原因未明者中輕、中、重低鉀分別為8例、6例、11例;原發(fā)性低鉀周期性麻痹患者(PHPP)中,輕、中、重低鉀分別為1例、3例、7例;Gitelman綜合征患者輕、中、重低鉀分別為0例、2例、2例;3例腎小管酸中毒(RTA)及3例Batter綜合征(BS)患者均為重度低鉀。⑥低鉀血癥患者入院時(shí)的臨床表現(xiàn),以原發(fā)病癥狀為主要表現(xiàn)者263例(54.56%),以周身無力為主要表現(xiàn)者94例(19.50%),以消化道癥狀為主要表現(xiàn)者(如厭食、惡心、嘔吐、腹瀉)者35例(7.26%),以間斷性肢體無力為主要表現(xiàn)就診者36例(7.47%),以頭暈、頭痛為主要表現(xiàn)就診者11例(2.28%),以肢體抽搐為主要表現(xiàn)者7例(1.45%)。結(jié)論:1.內(nèi)分泌相關(guān)性低鉀常見病因包括DM、PA、THPP、CS,其中除DM所致者以輕度低鉀為主,其余均以中重度低鉀為主。2.非內(nèi)分泌相關(guān)性低鉀常見病因?yàn)樗幬锛跋酪蛩?且以輕度低鉀為主,其余PHPP、RTA、BS均以重度低鉀為主。3.內(nèi)分泌科住院患者低鉀血癥以中老年患者為主,男女比例無明顯差異,且以輕度低鉀占多數(shù)。
[Abstract]:Objective: To retrospectively analyze the etiology, clinical manifestations, treatment and prognosis of hypokalemia in the Department of endocrinology in our hospital in recent 6 years, so as to understand the clinical characteristics of hypokalemia in endocrinology in order to improve the level of etiological diagnosis and treatment of hypokalemia. 016.05.31 482 cases of hypokalemia with complete data were admitted to the Endocrinology Department of our hospital. The incidental and transient factors were excluded. The clinical data of each patient, including sex, age, primary disease, clinical manifestations, auxiliary examinations, the causes of hypokalemia and the proportion of various causes, were collected and recorded by SPSS22.0 software. According to the analysis, the data of all continuous measurement variables were expressed as mean (+) standard deviation (x +) and variance analysis (F) was used for comparison between groups, and chi-square test (2) was used for comparison between groups as percentage (%). The results showed that: (1) In the past six years, the average age of hypokalemia patients ranged from 12 to 93 years, with an average age of 53.01 (+ 17.65). Among them, 119 (24.69%) were under 40 years old, 181 (37.55%) were between 40 and 60 years old, 182 (37.76%) were over 60 years old, and the majority of them were over 40 years old. According to the degree of hypokalemia, 279 cases (57.88%) were mild hypokalemia (3.0-3.5mmol/L, excluding 3.5mmol/L). Among them, 169 cases were mainly caused by diabetes mellitus, accounting for 60.57% of mild hypokalemia, followed by gastrointestinal causes and diuretics, 122 cases were moderate hypokalemia (2.5-3.0mmol/L, excluding 3.0mmol/L). There were 81 cases (16.81%) with severe hypokalemia (2.5mmol/L), mainly mild hypokalemia (16.81%). 10 cases (25.64%) were mild hypokalemia, 6 cases (23.08%) were moderate hypokalemia, 16 cases (61.54%) were severe hypokalemia, and 2 cases (6 cases) were mild, moderate and severe hypokalemia in CS. _In non-endocrine-related hypokalemia, 45 cases (65.22%) were mild hypokalemia, 17 cases (24.64%) were moderate and severe hypokalemia. 7 cases (10.14%) were hypokalemia; 40 cases (60.61%) were mild hypokalemia, 17 cases (25.75%) were moderate hypokalemia, 9 cases (13.64%) were severe hypokalemia; 8 cases (8 cases), 6 cases (11 cases) were mild, 6 cases) were severe hypokalemia and 11 cases (1 case) were mild, 3 cases (7 cases) were primary Hypokalemia Periodic Paralysis (PHPP); 7 cases (3 cases) were mild, moderate, severe and severe Gitelman syndrome. Hypokalemia were 0 cases, 2 cases, 2 cases, 3 cases of renal tubular acidosis (RTA) and 3 cases of Batter syndrome (BS) were all severe hypokalemia. _The clinical manifestations of hypokalemia patients were 263 cases (54.56%) with primary symptoms, 94 cases (19.50%) with general weakness and 94 cases (19.50%) with digestive tract symptoms. Nausea, vomiting and diarrhea were 35 cases (7.26%), 36 cases (7.47%) with intermittent limb weakness, 11 cases (2.28%) with dizziness and headache, and 7 cases (1.45%) with convulsions. Conclusion: 1. The common causes of endocrine-related hypokalemia include DM, PA, THPP, CS, and mild hypokalemia except DM. The common causes of non-endocrine-related hypokalemia were drugs and digestive tract factors, and mild hypokalemia was the main cause. The rest of PHPP, RTA, BS were mainly severe hypokalemia. 3. The majority of the hospitalized patients in endocrinology department were middle-aged and elderly patients with hypokalemia.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R591.1
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本文編號(hào)：2206598