中国全科医学2024，Vol.27Issue(9)：1068-1073,6.DOI:10.12114/j.issn.1007-9572.2023.0036
血钾水平预测2类肺动脉高压患者严重程度及住院时间的临床研究
Prediction of Severity and Length of Hospital Stay in Patients with Group 2 Pulmonary Hypertension Based on Serum Potassium Level
摘要
Abstract
Background Pulmonary hypertension(PH)is often caused by left heart disease(group 2 PH),which is difficult to diagnose early and with a high mortality rate.Potassium channel dysfunction is a marker of PH,however,the epidemiological data of the disease and the effect of potassium ions on PH still remain unclear.Objective To investigate the correlation of serum potassium level with myocardial markers,echocardiographic indicators and length of hospital stay in patients with group 2 PH,and evaluate the predictive value of serum potassium levels for the severity of group 2 PH,so as to provide the oretical basis for clinical diagnosis and treatment.Methods The clinical data of 400 adult inpatients diagnosed with group 2 PH in the First Hospital of Shanxi Medical University from January 2020 to December 2021 were retrospectively collected as follows:(1)general data:gender,age,BMI,length of hospital stay,smoking status,smoking index(SI)and drinking history;(2)underlying diseases(diabetes mellitus,hypertension);(3)laboratory data:serum potassium level,myocardial markers[procalcitonin,N-terminal pro-brain natriuretic peptide(NT-proBNP),cardiac troponin I,cardiac troponin T,creatine kinase-MB],echocardiographic indicators(left atrial diameter,right ventricular diameter,right atrial area,left ventricular ejection fraction,shortening fraction,peak tricuspid regurgitation velocity,pulmonary artery systolic pressure).The patients were divided into<3.5 mmol/L group(n=57),3.5-5.5 mmol/L group(n=340)and>5.5 mmol/L group(n=3)according to the serum potassium level.Spearman correlation analysis was used to explore the correlation of serum potassium level with myocardial markers and echocardiographic indicators.Log-rank(Mantel-Cox)test was used to compare the discharge rate of patients with different serum potassium levels.Receiver operating characteristic curve(ROC curve)was plotted to evaluate the predictive value of serum potassium level for the severity of group 2 PH.Results Procalcitonin and NT-proBNP levels of patients in the>5.5 mmol/L group were significantly higher than the<3.5 mmol/L group(P<0.05).Correlation analysis showed that serum potassium level was positively correlated with NT-proBNP(rs=0.133),peak tricuspid regurgitation velocity(rs=0.017)and pulmonary artery systolic pressure(PASP)(rs=0.126)(P<0.05).Serum potassium level was further classified as<3.5 mmol/L,3.5-3.9 mmol/L,4.0-4.9 mmol/L,5.0-5.5 mmol/L,and>5.5 mmol/L to investigate its relationship with length of hospital stay in depth.Log-rank(Mantel-Cox)testresults showed that for group 2 PH patients greater than average hospitalization levels,there was a significant difference in cumulative hospitalization rates among patients with different serum potassium levels(<3.5 mmol/L,3.5-3.9 mmol/L,4.0-4.9 mmol/L,5.0-5.5 mmol/L,>5.5 mmol/L)(P=0.022).ROC analysis showed that the diagnostic value of serum potassium level for non-mild PH(AUC=0.577,cut-off value=3.91 mmol/L,sensitivity=64.7%,specificity=52.5%)was similar to that of NT-proBNP(AUC=0.585,cut-off value=1 070.69 pg/mL,sensitivity=78.1%,specificity=39.6%),which can effectively predict the severity of group 2 PH.Conclusion Serum potassium level can predict the severity of group 2 PH and the length of hospital stay.Intervention of serum potassium levels may be one of the new approach to prevent and treat PH.关键词
肺动脉高压/血钾/超声心动图/住院时间/预测价值Key words
Pulmonary arterial hypertension/Serum potassium/Echocardiography/Hospital stay/Predictive value分类
医药卫生引用本文复制引用
郭耘廷,侯晓敏,白剑英,常铭洋,赵旭,孙琳,郑志发,施熠炜,秦小江..血钾水平预测2类肺动脉高压患者严重程度及住院时间的临床研究[J].中国全科医学,2024,27(9):1068-1073,6.基金项目
国家自然科学基金青年基金项目(81803282,82204042) （81803282,82204042）
山西省归国留学基金项目(2020-087,2020-075) （2020-087,2020-075）
山西省留学人员科技活动择优资助项目重点项目(20220019) （20220019）
山西省科技合作交流专项项目区域合作项目(202204041101022) （202204041101022）
国家卫生健康尘肺病重点实验室开放课题(YKFKT006) （YKFKT006）
