[1]杨惠安,俞晓玲,官升灿,等.成人登革热合并低钾血症的临床特征及其影响因素分析[J].福建医药杂志,2021,43(03):10-14.
　YANG Huian,YU Xiaoling,GUAN Shengcan,et al.Analysis of clinical characteristics and influencing factors of hypokalemia in adult patients with dengue[J].FUJIAN MEDICAL JOURNAL,2021,43(03):10-14.
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成人登革热合并低钾血症的临床特征及其影响因素分析()
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《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
43
期数:
2021年03期
页码:
10-14
栏目:
临床研究
出版日期:
2021-06-15

文章信息/Info

Title:
Analysis of clinical characteristics and influencing factors of hypokalemia in adult patients with dengue
文章编号:
1002-2600(2021)03-0010-05
作者:
杨惠安; 俞晓玲1; 官升灿; 叶寒辉2
福建医科大学孟超肝胆医院感染科(福州 350025)
Author(s):
YANG Huian;  YU Xiaoling;  GUAN Shengcan;  YE Hanhui
Department of Infectious Diseases,Mengchao Hepatobiliary Hospital of Fujian Medical University,Fuzhou,Fujian 350025,China
关键词:
登革热;  低钾血症;  危险因素
Keywords:
dengue;  hypokalemia;  risk factors
分类号:
R512.8 R373.3+3
文献标志码:
B
摘要:
目的 探讨成人登革热合并低钾血症的临床特征,并分析其影响因素。方法 回顾性分析我院收治的363例成人登革热的临床资料,根据入院血钾水平分为低钾血症组(<3.5 mmol/L)和正常血钾组(3.5～5.3 mmol/L),采用单因素分析和多因素logistic回归分析探讨低钾血症发生的相关因素。结果 成人登革热合并低钾血组179例(49.31%),正常血钾组184例(50.69%)。成人登革热病例低钾血症组和正常血钾组在乏力症状指标上差异有统计学意义(χ2=4.291,P=0.036),其余指标差异均无统计学意义(P>0.05)。经单因素与多因素logistic回归分析结果显示,入院前病程≤3 d[OR=1.906,95%CI(1.247,2.914),P=0.003]、合并高血压病[OR=2.166,95%CI(1.153,4.067),P=0.016]是成人登革热患者低钾血症的危险因素。结论 成人登革热患者低钾血症发生率高,尤其是疾病早期及合并高血压患者,因此,在治疗期间,应密切关注患者的血钾情况并及时补钾。
Abstract:
Objective To investigate the clinical characteristics and the influencing factors of hypokalemia in adult patients with dengue.Methods The clinical data of 363 patients with dengue in adults admitted to Mengchao Hepatobiliary Hospital of Fujian Medical University were retrospectively analyzed.The patients were divided into hypokalemia group(<3.5 mmol/L)and normal potassium group(≥3.5 mmol/L)based on the first serum potassium level.The influencing factors of hypokalemia were explored by univariate analysis and multivariate logistic regression analysis.Results Hypokalemia group accounted for 179 cases(49.31%),normal potassium group accounted for 184 cases(50.69%).There were statistically significant differences in fatigue symptoms between the hypokalemia group and the normal potassium group in adult patients with dengue(χ2=4.291,P=0.036),while there were no statistically significant differences in other indicators(P>0.05).The univariate and multivariate logistic regression analysis showed that the course of disease ≤3 days before admission[OR=1.906,95%CI(1.247,2.914),P=0.003] and basic disease hypertension [OR=2.166,95%CI(1.153,4.067),P=0.016] were the risk factors for hypokalemia among patients with dengue in adults.Conclusion The incidence of hypokalemia in adult patients with dengue is high,especially in the early stage of the disease and patients with hypertension.So during the treatment we should pay close attention to the serum potassium level of the patients and timely supplement potassium.

参考文献/References:

[1] Md-Sani S S,Md-Noor J,Han W H,et al.Prediction of mortality in severe dengue cases[J].BMC Infect Dis,2018, 18(1):232.
[2] 中华医学会感染病学分会,中华医学会热带病与寄生虫学分会,中华中医药学会急诊分会.中国登革热临床诊断和治疗指南[J].中华传染病杂志,2018,36(9):513-520.
[3] 陈灏珠,林果为.实用内科学[M].13版.北京:人民卫生出版社,2009:989.
[4] Duong V,Lambrechts L,Paul R E, et al.Asymptomatic humans transmit dengue virus to mosquitoes[J]. Proceedings of the National Academy of Sciences,2015,112(47):14688-14693.
[5] 张拥军,吴生根,王金章,等.福建省2015年本地登革热病例的病原学特征[J].中国人兽共患病学报,2019,35(1):28-33.
[6] 欧剑鸣,谢忠杭,林嘉威,等.福建省2008—2017年登革热疫情流行特征[J].海峡预防医学杂志,2018,24(6):18-20.
[7] Gupta N,Garg A,Chhabra P.Dengue infection presenting as acute hypokalemic quadriparesis[J].J Postgrad Med,2014,60(3):327-328.
[8] 陈燕清,唐小平,关玉娟,等.484例登革热临床实验诊断的分析[J].中华检验医学杂志,2008,31(1):82-85.
[9] 林萃才.潮州市人民医院登革热患者年龄分布及临床检验分析[J].医学信息,2018,31(18):88-90.
[10] Widodo D,Setiawan B,Chen K,et al.The prevalence of hypokalemia in hospitalized patients with infectious diseases problem at Cipto Mangunkusumo Hospital,Jakarta[J]. Acta Med Indones,2006,38(4):202-205.
[11] Malhotra H S,Garg R K.Dengue-associated hypokalemic paralysis:causal or incidental?[J]. J Neurol Sci,2014,340(1-2):19-25.
[12] Jha S,Ansari M K.Dengue infection causing acute hypokale-mic quadriparesis[J].Neurol India,2010,58(4):592-594.
[13] Ahlawat S K,Sachdev A.Hypokalaemic paralysis[J]. Post-grad Med J,1999,75(882):193-197.
[14] 邹林,陈绍森, 黄泽棋,等.广东佛山地区新发登革热流行的临床特征[J].中国热带医学,2015,15(11):1396-1398.
[15] Md-Sani S S,Md-Noor J,Han W H,et al.Prediction of mortality in severe dengue cases[J]. BMC Infect Dis,2018,18(1):232.
[16] Bardak S,Turgutalp K,Koyuncu M B,et al. Community-acquired hypokalemia in elderly patients:related factors and clinical outcomes[J].Int Urol Nephrol,2017,49(3):483-489.
[17] Liamis G,Rodenburg E M,Hofman A,et al.Electrolyte disorders in community subjects:prevalence and risk factors[J].Am J Med,2013,126(3):256-263.
[18] 丁霞,何青.高血压合并低钾血症疾病的病因综述[J].中华全科医师杂志,2015,14(1):70-73.
[19] Liamis G,Milionis H,Elisaf M.Blood pressure drug therapy and electrolyte disturbances[J].Int J Clin Pract,2008,62(10):1572-1580.

备注/Memo

备注/Memo:
基金项目:福建省感染性疾病临床重点专科建设项目; 福州市感染病医学中心建设项目(2018080306)
1 药学部; 2 通信作者,Email:yehanhui@163.com
更新日期/Last Update: 2021-06-15