目的:探讨高钾血症的发病率以及高钾血症与急性心肌梗死(AMI)患者预后之间的关系。方法:回顾性分析我院心内科196例AMI住院患者的资料,评价其住院期间血钾水平与院内病死率之间的关系以及纠正血钾异常是否有利于AMI患者的预后。根据血钾水平分组,将所有患者分为<5.0mmol/L、5.0~<5.5mmol/L,5.5~<6.0mmol/L,≥6.0mmol/L 4组,分别分析其院内病死率。结果:196例AMI患者中高钾血症发病率为22.4%,中、重度高钾血症发病率为8.2%。高钾血症患者住院6~12d,平均7.5d;非高钾血症患者住院4.0~7.0d,平均5.0d。与非高钾血症患者相比,高钾血症患者院内病死率较高[优势比(OR)=6.57,95%可信区间(CI):2.37~18.24,P<0.01]。未纠正血钾异常增加AMI患者院内病死率(OR=4.67,95%CI:1.10~19.85,P<0.01)。多元回归分析显示,急性肾损伤是导致高钾血症的高风险因素。结论:AMI患者中高钾血症较常见,随着血钾水平升高,院内病死率也逐渐增高。临床上积极处理高钾血症可能有利于改善AMI患者的预后。 Objective: To investigate the incidence of hyperkalemia and the relationship between hyperkalemia and prognosis in patients with acute myocardial infarction (AMI). Methods: A retrospective analysis of 196 cases of AMI hospitalized patients in our department of cardiology, evaluation of the relationship between the level of serum potassium and in-hospital mortality and to correct the prognosis of patients with AMI. All the patients were divided into four groups according to the level of potassium: 5.0 mmol / L, 5.0 mmol / L, 5.5 mmol / L, 5.5 mmol / L and 6.0 mmol / L. Results: The incidence of hyperkalemia in 196 AMI patients was 22.4%, and the incidence of moderate and severe hyperkalemia was 8.2%. Hyperkalemia patients hospitalized 6 ~ 12d, an average of 7.5d; non-hyperkalemia patients hospitalized 4.0 ~ 7.0d, an average of 5.0d. In-hospital mortality was higher in patients with hyperkalemia compared with non-hyperkalemia patients (odds ratio (OR) = 6.57, 95% confidence interval (CI): 2.37 to 18.24, P <0.01]. Uncorrected serum potassium abnormalities increased in-hospital mortality (OR = 4.67, 95% CI: 1.10-19.85, P <0.01). Multiple regression analysis showed that acute renal injury was a high risk factor for hyperkalemia. Conclusion: Hyperkalemia is more common in patients with AMI. With the increase of serum potassium levels, the in-hospital mortality rate also gradually increases. Active clinical treatment of hyperkalemia may be beneficial to improve the prognosis of AMI patients.