床旁超声评估脓毒症患者肝脏血流动力学参数与血乳酸的关系  

The Relationship Between Hepatic Hemodynamic Parameters and Blood Lactic Acid in Patients with Sepsis Evaluated by Bedside Ultrasound

作　　者：王斯宇 何新华[1] 张谱[1] 朱迎[1] 葛辉玉 郭树彬[1] 郭瑞君[1] Wang Siyu;He Xinhua;Zhang Pu;Zhu Ying;Ge Huiyu;Guo Shubin;Guo Ruijun(Department of Ultrasound Medicine,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院超声医学科,北京市100020

出　　处：《中国超声医学杂志》2022年第11期1245-1247,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 研究脓毒症患者肝脏血流动力学参数与血乳酸水平之间的关系。方法 回顾性分析24例符合脓毒症诊断标准患者的肝脏血流动力学参数与血乳酸的关系。结果 肝动脉峰值流速(HAPSV)、门静脉最大血流速度(PVVmax)与血乳酸呈负相关(r=-0.289,P=0.009;r=-0.249,P=0.025),肝动脉阻力指数(HARI)与血乳酸呈正相关(r=0.243,P=0.029)。与正常对照组比较,脓毒症患者的HARI明显升高(0.71±0.08&0.64±0.08,P<0.01),其中,高乳酸组的HARI明显高于正常乳酸组(0.74±0.08&0.68±0.07,P<0.01)。12例乳酸降低患者的24 h乳酸清除率(LCR)与HARI呈负相关(r=-0.617,P=0.033)。结论 HAPSV、PVVmax、HARI与脓毒症患者血乳酸水平有一定的相关性,其中HARI与24h-LCR密切相关。Objective To study the relationship between hepatic hemodynamic parameters and blood lactate level in patients with sepsis. Methods A total of 24 patients with sepsis underwent bedside liver ultrasonography every day after admission and clinical data were collected. The relationship between hepatic hemodynamic parameters and blood lactate level was analyzed retrospectively. Results Hepatic artery peak systolic velocity(HAPSV) and portal vein maximum velocity(PVVmax) were negatively correlated with blood lactate(r=-0.289, P=0.009;r=-0.249, P=0.025), and hepatic artery resistance index(HARI) was positively correlated with the level of blood lactate(r=0.243, P=0.029). Compared with the normal control group, the HARI of sepsis patients was significantly higher(0.71±0.08&0.64±0.08,P<0.01), and the HARI of high lactic acid group was higher than that of normal lactic acid group 0.74±0.08&0.68±0.07, P<0.01). The 24 h Lactic clearance rate in 12 patients with lactate deficiency was negatively correlated with HARI(r=-0.617, P=0.033). Conclusions HAPSV, PVVmax and HARI are correlated with the blood lactic acid level of sepsis patients, and HARI is closely correlated with 24 h-LCR.

关 键 词：脓毒症 乳酸 肝脏血流动力学 床旁超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R459.7[医药卫生—诊断学]