热射病患者各器官功能指标实验室检测结果分析  被引量:18

An analysis of laboratory results of parameters of organ function in patients with heat stroke

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作  者:叶君[1] 莫伟明[1] 陈燕[1] 杨爱平[1] 

机构地区:[1]浙江萧山医院检验科,浙江杭州311201

出  处:《中华危重病急救医学》2015年第8期658-661,共4页Chinese Critical Care Medicine

基  金:浙江省医药卫生科技计划项目(2012KYB171)

摘  要:目的:通过分析热射病(HS)患者各器官功能指标实验室检查结果,探讨其对HS并发症的评估作用,为临床治疗提供依据。方法采用回顾性研究方法,选择浙江萧山医院2011年至2014年收治的37例HS患者(HS组)和54例轻中度中暑患者(中暑组),记录所有患者各器官功能指标的实验结果,包括:①心肌标志物:肌钙蛋白I(TnI);②心肌酶谱:肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、天冬氨酸转氨酶(AST);③肾功能指标:尿素氮(BUN)、尿酸(UA)、血肌酐(SCr);④电解质:血清K+、Na+、Cl-;⑤凝血功能指标:凝血酶原时间(PT)、国际标准化比值(INR)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、D-二聚体;⑥血气分析指标:pH值、动脉血二氧化碳分压(PaCO2)、剩余碱(BE)、标准碳酸氢盐(SB)、实际碳酸氢盐(AB);⑦血常规:血小板计数(PLT);⑧肝功能指标:丙氨酸转氨酶(ALT)等。统计37例HS患者上述各实验室指标的异常率;比较两组患者各器官功能指标初始值的差异,以及HS患者CK、PLT初始值与治疗过程中极值(最高值或最低值)的差异。结果37例HS患者TnI、CK、 LDH、 AST、血Na+、ALT、 D-二聚体、PaCO2、AB初始值和治疗过程中CK最高值、PLT最低值的异常率分别为73.0%、70.3%、81.1%、78.4%、78.4%、70.3%、70.3%、70.3%、75.7%、81.1%、75.7%,均大于70%;其余各指标异常率均<70%。HS组与中暑组TnI、 CK、 LDH、 AST、血K+、血Na+、 D-二聚体、 PLT初始值比较差异均有统计学意义〔TnI(μg/L):(0.087(0.026,0.306)比0.007(0.004,0.110),Z=-7.017,P=0.000;CK(U/L):392.30(287.60,524.10)比137.10(106.33,607.80),Z=-7.930,P=0.000;LDH(U/L):317.98±122.74比207.85±57.71, t=1.678,P=0.000;AST(U/ObjectiveTo explore the role of parameters of organ function during heat stroke (HS) on the prognosis, and to form the treatment strategy through an analysis of parameters of organ function during HS. Methods A retrospective study was conducted. Thirty-seven patients with HS (HS group) and 54 patients with mild-to-moderate stroke (stroke group) admitted to Zhejiang Xiaoshan Hospital from 2011 to 2014 were enrolled. The experimental results of organs function indicators for patients were recorded including:① cardiac markers:troponin I (TnI);② myocardium zymogram: creatine kinase (CK), MB isoenzyme of creatine kinase (CK-MB), lactate dehydrogenase (LDH), and aspartate aminotransferase (AST);③ renal function indexes: blood urea nitrogen (BUN), uric acid (UA), and serum creatinine (SCr);④ electrolyte: serum K+, Na+, and Cl-;⑤coagulation function: prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB), and D-dimer;⑥ blood gas analysis: pH value, arterial partial pressure of carbon dioxide (PaCO2), base excess (BE), standard bicarbonate (SB), and actual bicarbonate (AB);⑦ routine blood test: blood platelet count (PLT);⑧ hepatic function: alanine aminotransferase (ALT). Abnormal rates of laboratory parameters of 37 HS patients were statistically analyzed. Various laboratory parameters of organs function as well as the initial value and extreme value (maximum or minimum value) during treatment of CK and PLT in HS patients were compared between two groups.Results The abnormal rates of 37 HS patients were more than 70%, including incipient value of TnI, CK, LDH, AST, serum Na+, ALT, D-dimer, PaCO2, AB, maximum value of CK, and minimum value of PLT, the abnormal rates being 73.0%, 70.3%, 81.1%, 78.4%, 78.4%, 70.3%, 70.3%, 70.3%, 75.7%, 81.1%, 75.7%, respectively. The abnormal rates of other parameters were

关 键 词:热射病 实验室结果 分析 

分 类 号:R594.11[医药卫生—内科学]

 

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