围手术期急性心肌梗死患者乳酸和乳酸清除率水平研究  

The research of level of lactate and lactate clearance in patients with perioperative acute myocardial infarction

作　　者：高洁[1,2] 张京岚[1,2] 叶清[1,2] 陈峣[1,2] 

机构地区：[1]首都医科大学附属北京安贞医院 [2]北京市心肺血管疾病研究所综合监护室,北京100029

出　　处：《心肺血管病杂志》2012年第6期713-715,共3页Journal of Cardiovascular and Pulmonary Diseases

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.

关 键 词：乳酸 乳酸清除率 急性心肌梗死 围手术期 

分 类 号：R54[医药卫生—心血管疾病]