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低血钾引起房室传导阻滞临床上少见。我院遇到4例低血钾引起Ⅱ度房室传导阻滞。其原发病是慢性肾小球肾炎、流行性出血热、风湿性心脏病二尖瓣狭窄伴关闭不全和尿路感染。4例血钾值是3.00mEq/L、3.30mEq/L、2.30mEq/L和2.90mEq/L。探讨其产生机理:可能由于低血钾使静息膜电位降低,Na~+内流减少,0相上升速度和幅度降低、传导性降低。心肌传导性降低可引起各种传导阻滞。4例中,1例口服氯化钾,3例静脉补充氯化钾。其中3例房室传导阻滞消失、血钾恢复正常,1例死于心脏骤停。
Hypokalemia caused by atrioventricular block is clinically rare. 4 cases of hypokalemia in our hospital caused Ⅱ degree atrioventricular block. The primary disease is chronic glomerulonephritis, epidemic hemorrhagic fever, rheumatic mitral stenosis with regurgitation and urinary tract infections. Four cases of potassium values were 3.00 mEq / L, 3.30 mEq / L, 2.30 mEq / L and 2.90 mEq / L. To explore its mechanism of production may be due to hypokalemia to reduce resting membrane potential, Na ~ + influx decreased, 0 phase rise rate and amplitude decreased conductivity decreased. Decreased myocardial conductivity can cause a variety of conduction block. In 4 cases, 1 case of oral potassium chloride, 3 cases of intravenous potassium chloride. 3 cases of atrioventricular block disappeared, serum potassium returned to normal, 1 patient died of cardiac arrest.