脓毒症患者乳酸与心功能相关性临床研究(1)
摘要：目的 探讨脓毒症患者血乳酸与机体应激反应的相关性。方法 回顾性收集我院2016年1月～6月诊断为的脓毒症患者相关数据，对符合纳入标准的脓毒症患者，收集每例患者入院时的乳酸和入院后6 h内的心功能数据(作为应激反应指标)，并采取Pearson相关分析法分析乳酸与心功能的相关性。结果 2016年1月～6月我院诊断为的脓毒症患者中有42例患者符合纳入标准，并收集到入院时的乳酸数据和入院后6 h内的心功能检查数据，42例患者入院时所测得的乳酸为(5.76±2.53)mmol/L，入院后6 h内行心脏超声检查所得心脏指数为(3.50±0.35)L/(min·m2)。乳酸与心脏指数的Pearson相关系数r为0.737，P<0.01，说明乳酸与心脏指数二者存在较强的相关性。结论 脓毒血症患者入院时的乳酸与入院后6 h内的心功能存在较强的正相关关系，心脏指数为应激反应的指标，乳酸可能为脓毒症患者早期机体的应激生物标志物之一，参与机体的应激反应，作为机体应激反应的一部分，乳酸的增高可能有助于提高机体在应激时的自我保护。
关键词：脓毒症；乳酸；心脏功能
, http://www.100md.com
Abstract：Objective To investigate the correlation between blood lactic acid and stress response in sepsis patients.Methods The data of sepsis diagnosed in our hospital from January to June in 2016 were retrospectively collected.In the patients with sepsis who were included in the standard， the lactic acid was collected at each hospital and the heart within 6 h after admission functional data(as a stress response indicator)，and Pearson correlation analysis was used to analyze the correlation between lactate and cardiac function.Results Of the sepsis patients diagnosed in our hospital from January to June in 2016，42 patients met the inclusion criteria and collected the lactic acid data at admission and the cardiac function data within 6 h after admission.42 patients (5.76±2.53)mmol/L，and the cardiac index was(3.50±0.35)L/(min· m2) within 6 h after admission.The Pearson correlation coefficient r of lactic acid and heart index was 0.737，P<0.01，which indicated that there was a strong correlation between lactate and heart index. Conclusion The lactic acid in patients with sepsis is positively correlated with the cardiac function within 6 h after admission.The cardiac index is the index of stress response.Lactic acid may be the stress organism of early sepsis in patients with sepsis one of the markers，involved in the body's stress response，as part of the body's stress response，increased lactic acid may help to improve the body's self-protection in stress.
, 百拇医药
Key words：Sepsis；Lactic acid；Heart function
膿毒症是重症监护室的常见病、多发病，特别是随着国际脓毒症指南的不断更新，诊断为脓毒症的患者的比例较以前提高，说明脓毒症的实际发病率比之前诊断出的比率更高。Martin GS[1]等统计美国从1979年到2000年脓毒症患者多达10319418例，每年脓毒症为住院患者的1.3%，并且每年以8.7%比例增加，死亡率超过四分之一，带来了沉重的经济负担。目前有大量针对脓毒症的相关研究，其发病机制也在不断的完善。乳酸作为组织代谢的中间产物，参与机体的多种生化反应，在保持机体功能正常进行中发挥着重要的作用，因此近年来，有大量针对乳酸在脓毒症中的作用的相关研究，而且最新指南也明确将检测乳酸作为诊断为脓毒症患者治疗的3 h目标内容之一(中华医学会重症医学分会)[2]。这是基于乳酸被作为组织灌注不良或低氧供的生物学标志物的观点。但这个观点目前仍存在争议。有研究发现乳酸作为糖异生的来源，在机体应激时为机体提供大部分的能量来源[3]。或许脓毒症患者机体乳酸的增高，与机体在紧张或运动等情况下一样，乳酸是机体应激反应的一部分，起着保护机体的作用。介于此两种观点的差异，进行此次研究，了解脓毒症患者机体乳酸增高与机体心功能的关系，从而说明乳酸增高与机体应激是否存在相关性。, http://www.100md.com(杨丽君 梁隆斌)
关键词：脓毒症；乳酸；心脏功能
, http://www.100md.com
Abstract：Objective To investigate the correlation between blood lactic acid and stress response in sepsis patients.Methods The data of sepsis diagnosed in our hospital from January to June in 2016 were retrospectively collected.In the patients with sepsis who were included in the standard， the lactic acid was collected at each hospital and the heart within 6 h after admission functional data(as a stress response indicator)，and Pearson correlation analysis was used to analyze the correlation between lactate and cardiac function.Results Of the sepsis patients diagnosed in our hospital from January to June in 2016，42 patients met the inclusion criteria and collected the lactic acid data at admission and the cardiac function data within 6 h after admission.42 patients (5.76±2.53)mmol/L，and the cardiac index was(3.50±0.35)L/(min· m2) within 6 h after admission.The Pearson correlation coefficient r of lactic acid and heart index was 0.737，P<0.01，which indicated that there was a strong correlation between lactate and heart index. Conclusion The lactic acid in patients with sepsis is positively correlated with the cardiac function within 6 h after admission.The cardiac index is the index of stress response.Lactic acid may be the stress organism of early sepsis in patients with sepsis one of the markers，involved in the body's stress response，as part of the body's stress response，increased lactic acid may help to improve the body's self-protection in stress.
, 百拇医药
Key words：Sepsis；Lactic acid；Heart function
膿毒症是重症监护室的常见病、多发病，特别是随着国际脓毒症指南的不断更新，诊断为脓毒症的患者的比例较以前提高，说明脓毒症的实际发病率比之前诊断出的比率更高。Martin GS[1]等统计美国从1979年到2000年脓毒症患者多达10319418例，每年脓毒症为住院患者的1.3%，并且每年以8.7%比例增加，死亡率超过四分之一，带来了沉重的经济负担。目前有大量针对脓毒症的相关研究，其发病机制也在不断的完善。乳酸作为组织代谢的中间产物，参与机体的多种生化反应，在保持机体功能正常进行中发挥着重要的作用，因此近年来，有大量针对乳酸在脓毒症中的作用的相关研究，而且最新指南也明确将检测乳酸作为诊断为脓毒症患者治疗的3 h目标内容之一(中华医学会重症医学分会)[2]。这是基于乳酸被作为组织灌注不良或低氧供的生物学标志物的观点。但这个观点目前仍存在争议。有研究发现乳酸作为糖异生的来源，在机体应激时为机体提供大部分的能量来源[3]。或许脓毒症患者机体乳酸的增高，与机体在紧张或运动等情况下一样，乳酸是机体应激反应的一部分，起着保护机体的作用。介于此两种观点的差异，进行此次研究，了解脓毒症患者机体乳酸增高与机体心功能的关系，从而说明乳酸增高与机体应激是否存在相关性。, http://www.100md.com(杨丽君 梁隆斌)