2010-2016年大连医科大学附属第一医院内分泌科住院患者482例低钾血症的病因分析
发布时间：2018-08-27 07:50
【摘要】：目的:回顾性分析近6年我院内分泌科住院患者低钾血症的发病原因,入院时的临床表现、治疗及转归,进而了解内分泌住院患者低钾血症的临床特点,以提高低钾血症的病因诊断及治疗水平。方法:利用病案查询系统回顾性分析2010.06.01-2016.05.31我院内分泌科收治的明确诊断为低钾血症且病例资料完整者482例,剔除偶然性及一过性因素,收集记录每位患者的临床资料,包括性别、年龄、原发病、临床表现、辅助检查、低钾血症的病因及各种原因所占比例,用SPSS22.0软件进行数据分析,所有连续计量变量资料以均数±标准差(x±s)表示,组间比较采用方差分析(F);计数资料以百分比(%)表示,组间比较采用卡方检验(χ2)。结果:我院内分泌科2010.06.01-2016.05.31共收治患者12167人次,其中低钾血症患者482例(占3.96%)。统计分析结果显示:①近6年所收治的低钾血症患者年龄12-93岁,平均年龄53.01±17.65岁,其中40岁以下119例(24.69%),40-60岁共181例(37.55%),60岁以上共182例(37.76%),主要以40岁以上中老年患者为主。②其中男性234例(48.55%),女性248例(51.45%),男女比例约为0.94:1。③根据低钾血症的程度划分,轻度低钾血症(血钾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,占轻度低血钾的60.57%,其次为消化道原因及利尿剂所致,中度低钾血症(血钾2.5-3.0mmol/L,不包含3.0mmol/L)122例(25.31%),重度低钾血症(血钾2.5mmol/L)81例(16.81%),以轻度低钾血症患者为主。④内分泌相关性低钾病因中血钾程度分布,糖尿病患者轻度低钾169例(75.45%),中度低钾46例(20.54%),重度低钾9例(4.02%),PA患者轻度低钾10例(25.64%),中度低钾19例(48.72%),重度低钾10例(25.64%),THPP患者中,轻度低钾4例(15.38%),中度低钾6例(23.08%),重度低钾16例(61.54%);CS患者轻、中、重低钾分别为2例、6例、4例。⑤非内分泌相关性低钾病因中血钾程度分布,消化道因素中,轻度低钾45例(65.22%),中度低钾17例(24.64%),重度低钾7例(10.14%);药物因素中,轻度低钾40例(60.61%),中度低钾17例(25.75%),重度低钾9例(13.64%);低钾原因未明者中轻、中、重低钾分别为8例、6例、11例;原发性低钾周期性麻痹患者(PHPP)中,轻、中、重低钾分别为1例、3例、7例;Gitelman综合征患者轻、中、重低钾分别为0例、2例、2例;3例肾小管酸中毒(RTA)及3例Batter综合征(BS)患者均为重度低钾。⑥低钾血症患者入院时的临床表现,以原发病症状为主要表现者263例(54.56%),以周身无力为主要表现者94例(19.50%),以消化道症状为主要表现者(如厌食、恶心、呕吐、腹泻)者35例(7.26%),以间断性肢体无力为主要表现就诊者36例(7.47%),以头晕、头痛为主要表现就诊者11例(2.28%),以肢体抽搐为主要表现者7例(1.45%)。结论:1.内分泌相关性低钾常见病因包括DM、PA、THPP、CS,其中除DM所致者以轻度低钾为主,其余均以中重度低钾为主。2.非内分泌相关性低钾常见病因为药物及消化道因素,且以轻度低钾为主,其余PHPP、RTA、BS均以重度低钾为主。3.内分泌科住院患者低钾血症以中老年患者为主,男女比例无明显差异,且以轻度低钾占多数。
[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.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R591.1
，
本文编号：2206598
[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.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R591.1
，
本文编号：2206598
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