心脏骤停后综合征患者早期乳酸水平的意义

目的研究早期血乳酸水平及乳酸清除率在院外患者发生心脏骤停后综合征中的意义。方法急救中心就诊的心脏骤停患者为研究对象，共40例符合条件的患者入选。将患者分为死亡组与成活组，成活组定义为康复出院者。采用GEMPremier3000血气分析仪检测乳酸值。结果存活组与死亡组在年龄、肾上腺素用量上无显著性差异（P〉0．05）。两组在心脏骤停即刻、12、24h乳酸比较都有显著性差异（P〈0．05）。两组在APACHEⅡ评分、12及24h乳酸清除率比较有显著性差异（P〈0．05）。结论对院外发生心脏骤停后综合征的患者，早期乳酸水平越低，乳酸清除率越高，生存率越高。以上结果提示心脏骤停后早期组织灌注与患者总体预后密切相关。

Value of Early Serum Lactate Levels and Lactate Clearance in Out-hospital Patients with Post-cardiac Arrest Syndrome

Objective To study the value of early serum lactate levels and lactate clearance of out-hospital patients with post-cardiac arrest syndrome. Methods We performed consecutive post-cardiac arrest syndrome patients in local hospital. The pa- tients were divided into death group and survived group. Primary endpoints consisted of survival to hospital discharge. Lactic acid val- ues test by The GEM Premier 3000 blood gas analyzer. Results A total of 40 patients were analyzed, the age and the epinephrine dos- age are no statistical difference in the two group. The mean initial, 12,24h lactate levels and Lactate clearance at both 12 h and 24 h in the victims were significantly higher than the in-hospital survivors （P〈 0.05）. Conclusion Early lactate levels, effective lactate clear- ance is associated with decreased overall out-hospital mortality in post-cardiac arrest syndrome patients. These ndings suggest that post-arrest tissue hypo-perfusion plays in an important role in early as well as overall mortality.