乳酸水平与颅脑损伤后迟发性颅内血肿的相关性研究

Correlative analysis of lactic acid level with late-onset intracranial hematoma after craniocerebral injury

目的 分析颅脑损伤后迟发性颅内血肿患者血液乳酸水平变化及其与迟发性颅内血肿的相关性. 方法 选取2009年5月—2012年12月收治的急性颅脑损伤后迟发性颅内血肿患者48例,其中男32例,女16例,设为损伤组.选择同期进行健康体检无系统性疾病的健康人群50例作为对照组,其中男35例,女15例.患者于入院时、诊断为迟发性颅内血肿时、治疗7,14 d时测量静脉血乳酸值,并与对照组静脉血乳酸值进行比较. 结果 入院时对照组血清乳酸值为（1.77 ±0.21） mmol/L,损伤组为（1.82±0.25） mmol/L（t=1.070,P＞0.05）.诊断为迟发性血肿时,损伤组血清乳酸值为（3.32±0.89） mmol/L,治疗7d后升高至（3.74±1.16） mmol/L,治疗14 d后降至（1.89 ±0.75） mmol/L.其中诊断为迟发性血肿时及治疗7d时损伤组血清乳酸值与对照组比较差异有统计学意义（P＜0.05）.各时相点乳酸水平与颅脑损伤具有相关性,但诊断为迟发性血肿时及治疗7d时相关系数较高,分别为0.986和0.989. 结论 乳酸水平与颅脑损伤后迟发性颅内血肿具有关联性,并与病情的变化有关,可以作为临床判断迟发性颅内血肿病情发展的参考依据.

Objective To analyze changes in lactic acid level in patients with late-onset intracranial hematoma after craniocerebral injury and investigate their relativity.Methods Forty-eight patients with late-onset intracranial hematoma after craniocerebral injury treated in our hospital between May 2009 and December 2012 were enrolled as observation group.There were 32 males and 16 females.Moreover,50 cases checked up in our hospital during the same period were studied as health population controls,including 35 males and 15 females.Level of lactic acid was measured on admission,at the time of definite diagnosis as well as at days 7 and 14 after treatment and compared between groups.Results Level of lactic acid was （1.77 ±0.21） mmol/L in control group and （1.82 ± 0.25） mmol/L in observation group respectively on admission （t =1.070,P ＞ 0.05） ; Level of lactic acid was （3.32 ± 0.89） mmol/L in observation group at the time of definite diagnosis,which increased to （3.74 ± 1.16） mmol/L at days 7 after treatment and decreased to （1.89 ±0.75） mmol/L at days 14 after treatment.When diagnosed and treated for 7 days,level of lactic acid differed significantly between the two groups （P ＜ 0.05）.Level of lactic acid related to craniocerebral injury at each time point,but higher correlation coefficient was observed at the time of definite diagnosis and 7 days after treatment with 0.986 and 0.989 respectively.Conclusion Level of lactic acid relates to late-onset intracranial hematoma after craniocerebral injury,which can be used as reference for progression of the disease.