CAJ | 학술논문

目的：探讨急性重度一氧化碳中毒患者血清乳酸清除率水平的变化规律，为急性一氧化碳中毒迟发性脑病的早诊断及预后提供新的依据。方法286例确诊为急性重度一氧化碳中毒患者，根据入院时血清乳酸水平分为高乳酸血症组、低乳酸血症组，所有患者均在0h、治疗后6h、24 h、72 h 行动脉血乳酸检测，分别计算乳酸清除率及进行 APACHEⅡ评分，同时高乳酸血症组以6 h 乳酸清除率的高低分为高乳酸清除率组（＞10%）和低乳酸清除率组（≤10%），分别比较两组患者乳酸清除率、APACHEⅡ评分变化与迟发脑病发生率关系。结果高、低乳酸血症组不同时间乳酸清除率及 APACHEⅡ评分的比较，差异有统计学意义（P＜0.05）；高、低乳酸清除率组不同时间乳酸清除率及 APACHEⅡ评分的比较，差异有统计学意义（P＜0.05）。不同时间段血乳酸清除率与APACHEⅡ评分呈负相关性。结论乳酸清除率在急性一氧化碳中毒性迟发性脑病患者的表达规律，为早期预防，评估预后提供广阔前景。
목적：탐토급성중도일양화탄중독환자혈청유산청제솔수평적변화규률，위급성일양화탄중독지발성뇌병적조진단급예후제공신적의거。방법286례학진위급성중도일양화탄중독환자，근거입원시혈청유산수평분위고유산혈증조、저유산혈증조，소유환자균재0h、치료후6h、24 h、72 h 행동맥혈유산검측，분별계산유산청제솔급진행 APACHEⅡ평분，동시고유산혈증조이6 h 유산청제솔적고저분위고유산청제솔조（＞10%）화저유산청제솔조（≤10%），분별비교량조환자유산청제솔、APACHEⅡ평분변화여지발뇌병발생솔관계。결과고、저유산혈증조불동시간유산청제솔급 APACHEⅡ평분적비교，차이유통계학의의（P＜0.05）；고、저유산청제솔조불동시간유산청제솔급 APACHEⅡ평분적비교，차이유통계학의의（P＜0.05）。불동시간단혈유산청제솔여APACHEⅡ평분정부상관성。결론유산청제솔재급성일양화탄중독성지발성뇌병환자적표체규률，위조기예방，평고예후제공엄활전경。
Objective To study the changes of levels of lactate clearance rate in patients with severe acute carbon monoxide poisoning, provides a new basis for early diagnosis and prognosis of delayed encephalopathy after acute carbon monoxide poisoning. Methods 286 patients with acute severe carbon monoxide poisoning, according to the serum lactic acid level were divided into high lactic acidosis group, low lactic acidosis group, all the patients were artery blood lactate levels in 0 h, 6 h, 24 h, 72 h after treatment, lactate clearance rate and APACHE Ⅱ score were calculated, and high lactic acid in the group with 6 h lactate clearance rate is divided into high lactate clearance group (>10%) and low lactate clearance group (≤10%). Patients were compared with lactate clearance rate, APACHE II score changes and the relationship between incidence of delayed encephalopathy. Results Relatively high, low lactic acidosis group at different time of lactate clearance rate and APACHE Ⅱ score, the difference was statistically significant (P<0.05); high, low lactate clearance group at different time of lactate clearance rate and APACHE Ⅱ score, the difference was statistically significant (P<0.05). Different time blood lactate clearance rate and APACHE score showed negative correlation. Conclusion Expression of lactate clearance rate in patients with delayed encephalopathy after acute carbon monoxide, provides a broad prospect for the early prevention and evaluation of prognosis.