摘要
目的:通过冠心病患者术后早期动脉血乳酸水平及乳酸清除率,评价其对围术期急性心肌梗死(perioperative acute myocardial infarction,PAMI)的发病、预后的提示作用。方法:入选2010年1月至2012年3月,入住我院SICU的冠心病患者,比较其中确诊为围术期PAMI的35例患者,及围术期平稳过渡的31例患者,动脉乳酸值及血乳酸清除率进行回顾性分析。结果:研究显示,PAMI患者初始乳酸水平(3.05±1.18)mmol/L较非心肌梗死患者(1.70±0.79)mmol/L明显增高,而6 h乳酸水平分别为心肌梗死组(2.10±0.89)mmol/L非心肌梗死组(0.96±0.41)mmol/L,差异具有统计学意义(P<0.05),心肌梗死患者中初始乳酸水平在KillipⅠ、Ⅱ级(2.24±0.88)mmol/L及KillipⅢ、Ⅳ级(3.89±1.45)mmol/L之间,差异有统计学意义(P<0.05),而患者术后心肌梗死乳酸清除率则无明显减少,显示乳酸清除率不能明确提示PAMI发生概率上升。结论:乳酸测量可作为ICU医师对PAMI的另一有效的预警指标。
Objective：To study the perioperative level of lactate（LA）and lactate clearance（LC）in patients with coronary artery disease（CAD）and evaluate its warning effect in perioperative acute myocardial infarction（PAMI）.Methods：Contrast the level of lactate and lactate clearance in 66 patients,including 35 patients with PAMI and 31 CAD patients who smooth transit the perioperative stage.Results：Higher levels of initiate LA were found in PAMI patients（3.05±1.18）mmol/L compare with no PAMI group（1.70±0.79）mmol/L（P〈0.05）.The statistics difference was found in PAMI patients（2.10±0.89）mmol/L compare with no PAMI group（0.96±0.41）mmol/Lin level of 6 h LA.Comparing initiate LA of patients with PAMI,the statistics difference was found between Killip Ⅰ、Ⅱ degree group（2.24±0.88）mol/Land Killip Ⅲ、Ⅳ degree group（3.89±1.45）mmol/L.Conclusion： The result show that LA level is a good warning indicator for PAMI.
出处
《心肺血管病杂志》
CAS
2012年第6期713-715,共3页
Journal of Cardiovascular and Pulmonary Diseases
关键词
乳酸
乳酸清除率
急性心肌梗死
围手术期
Lactate
Lactate clearance
Perioperative
Acute myocardial infarction
