血乳酸、血清淀粉酶水平与急诊心源性休克患者预后的关系  

Relationship Between the Level of Blood Lactate and Serum Amylase and the Prognosis of Emergency Cardiogenic Shock Patients

作　　者：豆路沙 耿玉安 DOU Lusha;GENG Yu’an(Department of Emergency,the Third People’s Hospital of Henan Province,Zhengzhou 450000,China)

机构地区：[1]河南省直第三人民医院急诊科,河南郑州450000

出　　处：《河南医学研究》2025年第5期849-853,共5页Henan Medical Research

摘　　要：目的探讨血乳酸、血清淀粉酶水平与急诊心源性休克患者预后的关系。方法回顾性收集2019年3月至2023年3月河南省直第三人民医院收治的62例急诊心源性休克患者的临床资料,根据患者入院后28 d预后情况分为病死组(38例)和存活组(24例)。所有患者入院时均接受血乳酸、血清淀粉酶水平检测,并记录患者基线资料,分析血乳酸、血清淀粉酶水平与急诊心源性休克患者预后的关系。结果病死组急性生理学与慢性健康状况评分系统Ⅱ评分(APACHEⅡ)评分与存活组比较,差异有统计学意义(P<0.05);入院时,病死组血乳酸、血清淀粉酶水平高于存活组,差异有统计学意义(P<0.05);经logistic回归分析,结果显示,血乳酸、血清淀粉酶水平、APACHEⅡ评分是急诊心源性休克患者预后的危险因素(OR>1,P<0.05);绘制受试者工作特征曲线结果显示,血乳酸、血清淀粉酶单独及联合预测急诊心源性休克患者预后的曲线下面积均>0.7,具有一定预测价值。结论高血乳酸、血清淀粉酶水平是急诊心源性休克患者预后不良的危险因素,且具有一定预测价值,早期检测血乳酸、血清淀粉酶水平对评估急诊心源性休克患者的预后具有积极意义。Objective To explore the relationship between the level of blood lactate and serum amylase and the prognosis of emergency cardiogenic shock patients.Methods Clinical data of 62 emergency cardiogenic shock patients admitted to the Third People’s Hospital of Henan Province from March 2019 to March 2023 were retrospectively collected.According to the 28 day prognosis after admission,the patients were divided into a death group(38 cases)and a survival group(24 cases).All patients were tested for blood lactate and serum amylase levels upon admission,and baseline data were recorded to analyze the relationship between blood lactate and serum amylase levels and the prognosis of emergency cardiogenic shock patients.Results There was a statistical significant difference in acute physiology and chronic health evaluation scoring system(APACHEⅡ)scores between the death group and the survival group(P<0.05).At admission,the levels of blood lactate and serum amylase in the death group were higher than those in the survival group,with a statistical significant difference(P<0.05).Through logistic regression analysis,the results showed that blood lactate,serum amylase levels APACHEⅡscore was a risk factor for prognosis in emergency cardiogenic shock patients(OR>1,P<0.05).The results of drawing receiver operating characteristic curves showed that both blood lactate and serum amylase alone and in combination predicted the prognosis of emergency cardiogenic shock patients with area under the curve>0.7,which had certain predictive value.Conclusion High blood lactate and serum amylase levels are risk factors for poor prognosis in emergency cardiogenic shock patients,and have certain predictive value.Early detection of blood lactate and serum amylase levels has positive significance in evaluating the prognosis of emergency cardiogenic shock patients.

关 键 词：心源性休克 血乳酸 淀粉酶 预后 

分 类 号：R459.7[医药卫生—急诊医学]