急诊多器官功能障碍综合征患者血氧分压与乳酸浓度的相关性

Correlation studies between blood lactate concentration and partial pressure of arterial oxygen of emergency multiple organ dysfunction syndrome patients

目的 :研究急诊多器官功能障碍综合征 (MODS)患者血乳酸 (L AC)浓度与血氧分压 (Pa O2 )的相互关系 ,为判断此类患者的组织缺氧提供有价值的生化指标。方法 :分别用 VITROS2 5 0干化学分析仪和 AVLOMNI3血气分析仪测定急诊收治的 10 3例内科急症伴 MODS患者的血 L AC浓度和血气 ,并以 38例健康志愿者血 L AC作为对照。结果 :L AC异常患者 4 1例 ,血气分析异常 82例。与志愿者比较 ,血气分析异常患者组L AC结果明显升高 (P<0 .0 0 1) ,而血气分析结果正常组 L AC无明显升高。患者中 Pa O2 低于正常的 6 5例 ,其Pa O2 与 L AC呈明显的负相关 (r=0 .5 12 ,P<0 .0 0 1) ;而在 Pa O2 正常的 38例患者中 ,Pa O2 与 L AC无明显相关 (r=0 .0 2 3,P>0 .0 5 ) ,其中有 12例患者 L AC异常。结论 :L AC浓度的变化虽与 Pa O2 有一定相关性 ,但两者的变化并非完全一致 ,特别是 Pa O2 正常患者 ,血 L AC测定有助于了解组织细胞缺氧情况。急诊 MODS患者需同时监测血气和 L

Objective:To study the correlation between blood lactate concentrations and partial arterial oxygen pressure (PaO 2) of emergency patients with multiple organs dysfunction syndrome (MODS), and to provide valuable biochemical index for judging the anoxemia condition of tissues. Methods:The blood lactate concentrations and blood gas in 103 emergency patients with MODS were determined by VITROS 250 dry chemistry and AVL OMNI3 blood gas analyzer respectively, blood lactate concentrations in 38 healthy volunteers were measured and served as controls.Results:Among the observed 103 patients, there were 41 cases with abnormal blood lactate concentrations and 82 cases with abnormal blood gas results. Comparing with healthy controls, lactate concentrations in the patients with abnormal blood gas increased significantly ( P <0 001), while no significant difference was found for those with normal blood gas group ( P >0 05). The significant negative correlations were found between PaO 2 and lactate in patients with lower PaO 2 ( r = 0 512, P <0 001 ), whereas there were no significant correlation in patients with normal PaO 2 ( r =0 023, P >0 05), of them there were 12 patients with elevated lactate.Conclusions:Although there are marked correlation between lactate and normal PaO 2 value, some special cases are not evident, especially for the normal PaO 2 cases. Blood lactate is an important biochemical marker to reflect anoxemia condition in tissue and cells. Both blood gas and lactate tests are necessary for emergency MODS patients.