低血钾在短暂性脑缺血发作和急性轻型缺血性脑卒中的差异及意义

目的 分析短暂性脑缺血发作（transient ischemic attack, TIA）和急性轻型缺血性脑卒中（minor ischemic stroke, MIS）的低血钾的差异的原因及意义。方法 选取发病24h内就诊的67例TIA和228例MIS患者，对血钾值及其他各类临床数据进行统计学分析。结果 MIS组和TIA组间高血压、颈动脉斑块、糖化血红蛋白、同型半胱氨酸、超敏肌钙蛋白、CK-MB、pro-BNP、白细胞、血钾、血氯水平差异有统计学意义(P＜0.05)。Logistic回归分析发现，低血钾（OR： 4.328，95%CI： 1.012～18.504）和颈动脉斑块（OR： 11.372，95%CI： 3.461～37.371）与MIS显著相关；且发病3h内就诊的MIS组患者低血钾发生率（33.3%）明显高于TIA组（0%）(P＜0.05)。结论 发病早期，MIS相比TIA发生低血钾的风险更高，考虑发病早期的低血钾有助于提示急性缺血性脑卒中的发生。
Objective To investigate hypokalemia between transient ischemic attack (TIA) and acute minor ischemic stroke (MIS). Methods Sixty-seven TIA and 228 MIS patients admitted within 24 h after onset were enrolled in the study. The clinical data and serum potassium levels were analyzed. Results There were significant differences in clinical and laboratory findings between MIS group and TIA group. Multivariate Logistic regression showed that hypokalemia （OR： 4.328, 95%CI： 1.012-18.504, P＜0.05）and carotid plaque（OR： 11.372, 95%CI： 3.461-37.371, P＜0.05）were risk factors for development of MIS. The incidence of hypokalemia at 3h after onset in MIS group was significantly higher than that in TIA group (33.3% vs 0%, P＜0.05). Conclusion Hypokalemia is likely occur in early stage of MIS, and early detection of hypokalemia would help to suggest the occurrence of acute ischemic stroke