乳酸酸中毒与非乳酸增高性酸中毒对急性心肌梗死患者短期预后的影响  

Effect of lactic acidosis and non-lactic elevated acidosis on short-term prognosis of patients with acute myocardial infarction

作　　者：农大雄 张景昌[2] 雷唤启 何奇生 黄培荣 NONG Daxiong;ZHANG Jingchang;LEI Huanqi;HE Qisheng;HUANG Peirong(The First Department of Internal Medicine,Nanning Yongning District Hospital of Traditional Chinese Medicine,Nanning 530200,Guangxi,China;Department of Cardiology,the Second Nanning People′s Hospital,Nanning 530031,Guangxi,China;Department of Clinical Laboratory,Nanning Yongning District Hospital of Traditional Chinese Medicine,Nanning 530200,Guangxi,China)

机构地区：[1]南宁市邕宁区中医医院内一科,广西南宁市530200 [2]南宁市第二人民医院心内科,广西南宁市530031 [3]南宁市邕宁区中医医院检验科,广西南宁市530200

出　　处：《广西医学》2023年第11期1291-1295,共5页Guangxi Medical Journal

基　　金：广西南宁市科学研究与技术开发计划项目(20183041-4);广西壮族自治区中医药管理局自筹经费科研课题(GXZYZ20210551)。

摘　　要：目的探讨乳酸酸中毒与非乳酸增高性酸中毒对急性心肌梗死(AMI)患者短期预后的影响。方法回顾性分析87例合并酸中毒的AMI患者的临床资料,根据乳酸水平分为乳酸酸中毒组42例和非乳酸增高性酸中毒组45例。比较两组患者的一般临床资料,以及确诊后30 d、90 d的死亡者比例及生存率。采用多因素COX回归模型分析AMI患者短期预后的影响因素。结果乳酸酸中毒组的确诊后30 d死亡者比例和确诊后90 d死亡者比例均高于非乳酸增高性酸中毒组,确诊后30 d生存率和90 d生存率均低于非乳酸增高性酸中毒组(均P<0.05)。多因素COX回归分析结果显示,校正相关因素后,酸中毒类型是合并酸中毒的AMI患者短期预后的影响因素(P<0.05),其中合并乳酸酸中毒的AMI患者的确诊后30 d、90 d死亡风险是合并非乳酸增高性酸中毒的AMI患者的6.018倍、5.369倍。结论相比于合并非乳酸增高性酸中毒的AMI患者,合并乳酸酸中毒的AMI患者的短期预后更差。Objective To explore the effect of lactic acidosis and non-lactic elevated acidosis on short-term prognosis of patients with acute myocardial infarction(AMI).Methods The clinical data of 87 AMI patients and concomitant acidosis were retrospectively analyzed,and they were divided into lactic acidosis group(42 cases)or non-lactic elevated acidosis group(45 cases)according to the level of lactic acid.The general clinical data,and the proportions of the deceased and survival rate after 30 and 90 days of confirmed diagnosis were compared in patients between the two groups.The influencing factors for short-term prognosis of AMI patients were analyzed by using the multivariate COX regression model.Results The lactic acidosis group exhibited higher proportions of the deceased after 30 and 90 days of confirmed diagnosis as compared with the non-lactic elevated acidosis group,and lower survival rates after 30 and 90 days of confirmed diagnosis as compared with the non-lactic elevated acidosis group(all P<0.05).The results of multivariate COX regression analysis revealed that after adjusting for relevant factors,type of acidosis was the influencing factor for short-term prognosis of AMI patients and concomitant acidosis(P<0.05),therein the death risk of AMI patients and concomitant lactic acidosis after 30 and 90 days of confirmed diagnosis was 6.018 times and 5.369 times higher than that of AMI patients and concomitant non-lactic elevated acidosis.Conclusion Compared with AMI patients and concomitant non-lactic elevated acidosis,AMI patients and concomitant lactic acidosis obtain a poorer short-term prognosis.

关 键 词：酸中毒 乳酸酸中毒 急性心肌梗死 短期预后 

分 类 号：R542.22[医药卫生—心血管疾病]