血乳酸监测在急性心肌梗死合并心力衰竭患者救治中的意义  

Significance of blood lactate monitoring in the treatment of patients with acute myocardial infarction complicated with heart failure

作　　者：黄於娟[1] 

机构地区：[1]广西柳州市人民医院心内科一病区,545006

出　　处：《中国社区医师》2018年第3期115-117,119,共4页Chinese Community Doctors

摘　　要：目的:探讨血乳酸监测对急性心肌梗死合并心力衰竭患者病情严重程度及评价预后的意义。方法:收治急性心肌梗死合并心力衰竭患者84例。所有患者均监测LA,根据入院时LA的水平将患者分为LA增高组和LA正常组,各42例。结果:与LA正常组相比,LA增高组患者APACHEⅡ评分、BNP、Tn I峰值水平较高,PCI术中发现冠脉病变更严重,PCI后2h ST持续抬高者较多,LVEF值显著下降,住院期间并发症发生率增加,监护室入住时间长,并且在随访观察中主要心血管事件发生率增加(P<0.05)。结论:测定急性心肌梗死合并心力衰竭患者的血乳酸,对预测病情的危重程度及预后具有较好的临床意义。Objective:To investigate the significance of blood lactate monitoring in patients with acute myocardial infarction complicated with heart failure and prognosis evaluation.Methods:84 patients with acute myocardial infarction complicated with heart failure were enrolled.All patients were monitored with LA,patients were divided into the LA increasing group and the LA normal group according to the level of LA at admission,with 42 cases in each group.Results:Compared with the normal LA group,patients in the LA increasing group has higher levels on APACHE score,BNP and Tn I peak value,in coronary artery disease were found more serious during the PCI surgery,2 hours after PCI with more ST segment elevation,the LVEF value decreased significantly,increase the incidence of complications during hospitalization,ICU stay a long time,and the incidence of main cardiovascular events increased during followed-up observation(P<0.05).Conclusion:Determination of blood lactic acid in patients with acute myocardial infarction complicated with heart failure has a good clinical significance in predicting the severity and prognosis of the disease.

关 键 词：乳酸 急性心肌梗死 心力衰竭 预后 

分 类 号：R541.6[医药卫生—心血管疾病] R542.22[医药卫生—内科学]