慢性肺心病急性发作患者血乳酸浓度变化与预后关系  

The Changes of Lactate in Patients with Acute Exacerbation of Chronic Pulmonary Heart Disease and Its Prognosis

作　　者：杜雪梅[1] 李燕屏[1] 林珮仪[1] 江慧琳[1] 周慧群[1] 

机构地区：[1]广州医学院第二附属医院急诊科,510260

出　　处：《岭南急诊医学杂志》2006年第1期14-15,共2页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨血乳酸在慢性肺心病急性发作期的致病机制与预后关系。方法:慢性肺心病急性发作患者共68例,生存组38例,死亡组30例,每组均动态观察血乳酸浓度的变化,测定初始、12、24、48、72hr血乳酸浓度,入院初同时观察其血气分析中pH值、PO2、平均动脉压及24hrAPACHEⅡ评分,比较生存组和死亡组资料。结果:1、生存组血乳酸水平明显低于死亡组,且下降趋势大于死亡组。2、两组APACHEⅡ评分有显著差异,血乳酸水平与APACHEⅡ呈正相关。结论:肺心病病人急性发作期血乳酸越高,病人预后越差,乳酸浓度变化对判定肺心病病人急性发作期病情发展和预后有意义。Objective： To study the changes of blood lactate in patients with acute exacerbation of chronic pulmonary heart disease （CPHD）, and to observe its severity, assess its prognosis. Method： Sixty-eight patients with CPHD at the acute exacerbation stage were studied. The lactate levels were measured at the time of admission, 12, 24, 48 and 72 h. pH, PO2, mean arterial pressure and APACHE Ⅱ score were recorded at the time of admission. Result： 38 patients were died, the others survived. The level of lactate and APACHE Ⅱ score in the patients with CPHD at the death group were higher than those in the patients at the survival group （P 〈 0.05）. There were growing tendencies of lactate for dead group. Conclusion： The advance of lactate exists in patients with CPHD, and it may play an important role in the development of CPHD. The level of lactate can serve as indicators to observe the disease severity and assess its prognosis.

关 键 词：肺心病 乳酸 预后 

分 类 号：R541.5[医药卫生—心血管疾病] R972.4[医药卫生—内科学]