摘要
目的:评价围手术期不同血糖控制水平对血清乳酸的影响,探讨血糖与乳酸的关系,寻求保护心肌的新途径。方法:把入选志愿者随机分为实验组(n=38)与对照组(n=33),实验组进行胰岛素强化治疗,对照组进行传统标准治疗,分别于患者换瓣术后在ICU不同时间点抽取动脉血进行血气分析,并收集相关资料数据进行分析。结果:两组病例的血糖均有一个血糖降低到升高再恢复的过程;两组病例的乳酸均有一个升高到降低再升高然后恢复的过程,尤其以术后2h为最高;两组病例血糖、乳酸水平在术后2,12,24h差异有统计学意义(P<0.01),其余监测指标差异无统计学意义(P>0.05)。结论:瓣膜置换术后2,12,24h血糖与乳酸水平变化趋势一致。通过控制血糖降低血乳酸水平,为该类疾病的心肌保护提供实验依据。
Objective To evaluate the effect of different control levels of glucose on the serum lactic acid during operation, and to investigate the relation between glucose and lactic acid to find a new way of myocardial protection. Methods Volunteers were divided into an experiment group （ n = 38 ） and a control group （n = 33 ） by random sampling and double blind method. The experiment group received intensive insulin therapy and the control group received traditional therapy. The arterial blood gas samples of all the patients at different time points after the operation were harvested in the intensive care unit for blood gas analysis. The related data were collected and analyzed. Results The serum glucose level in the 2 groups decreased firstly, then increased, and recovered finally. The serum lactic acid level in the 2 groups increased firstly, decreased later, then reincreased, and recovered finally. The highest level of the serum lactic acid was found 2 hours after the operation. There were significant differences in serum glucose and lactic acid levels at 2, 12, and 24 h after the operation in the two groups （P 〈0. 01）. The other data were not significant （P 〉0.05）. Conclusion The variation of serum glucose and lactic acid level at 2, 12, 24 h after the valve replacement is consistent and significant. The serum lactic acid in the serum may be decreased by controlling the blood glucose, which provides experiment basis for myocardial protection.
出处
《中南大学学报（医学版）》
CAS
CSCD
北大核心
2009年第5期443-447,共5页
Journal of Central South University ：Medical Science
基金
湖南省卫生厅科技计划(B2006-056)~~
关键词
血糖
乳酸
瓣膜置换
体外循环
blood glucose
lactic acid
valve replacement
cardio-pulmonary bypass
