呼吸衰竭患者血乳酸水平与急性肾损伤之间关系的研究  

Study on the Relationship between Artery Lactate and Acute Kidney Injury in Respiratory Failure Patients

作　　者：郑君德[1] 陈涛[1] 罗红[2] 刘汉欣[1] 高月亭[1] 蒋月婷[1] 王鹏坤[1] 肖洪广[1] 

机构地区：[1]广州医学院第一附属医院检验科,广州510120 [2]广州医学院检验系本科生,广州510182

出　　处：《热带医学杂志》2010年第9期1045-1047,共3页Journal of Tropical Medicine

基　　金：第八轮广东省高等学校重点扶持学科资助(粤教科[2007]26号)

摘　　要：目的探讨呼吸衰竭患者血乳酸水平与急性肾损伤之间的关系,为肾损伤提供新的参考指标。方法收集在广州医学院第一附属医院住院治疗的呼吸衰竭病人动脉血,测定乳酸值。根据血肌酐变化,以AKI的RIFLE诊断标准分为3期,分析血乳酸与肾损伤之间的关系。结果肾损伤1期与2期或3期间血乳酸差异显著(P<0.05),但2期与3期之间的差异无统计学意义(P=0.49);血乳酸水平与肾功能分期相关(r=0.347,P<0.05),乳酸水平随肾损伤加重而上升,而氧张力PX水平在各期间差异无统计学意义。结论动脉血乳酸水平比PX更利于早期提示呼吸衰竭患者肾脏缺氧造成的急性功能损伤。Objective To explore the relationship between lactate and acute kidney injury in patients suffered from respiratory failure.Methods In-patients suffered from respiratory failure in the first affiliated hospital of Guangzhou Medical College were chosen in this study.Arterial blood samples were collected for blood-air analysis and lactic acid was analyzed within two hours.Creatinine was tested for determination of the phase of acute kidney injury either.Results There was a significant difference between the first phase of renal damage and the second or the third phase （P0.05）.But no statistical difference was observed between the second and the third phase.And the difference of the PX between the three phases was also not significant.Positive correlation could be found between the level of lactate and the renal damage phase （r=0.347, P0.05）.Conclusion Arterial blood lactate is a better index than PX for the monitoring of renal damage, especially for patients suffering from respiratory failure.

关 键 词：乳酸 肌酐 呼吸衰竭 急性肾损伤 

分 类 号：R446.129[医药卫生—诊断学] R563.8[医药卫生—临床医学]