摘要
目的:通过检测急性上消化道出血患者血清乳酸脱氢酶(lactate dehydrogenase,LDH)、D-乳酸(D-lactic acid,D-LA)水平,探究二者与患者预后的关系。方法:选择2018年12月-2023年1月在邯郸市人民医院住院治疗的急性上消化道出血患者216例作为试验组,体检健康人员132例作为对照组。收集急性上消化道出血患者临床资料、AIMS65评分和生化指标,检测试验组和对照组血清LDH、D-LA水平。根据入院后30d内存活情况,将急性上消化道出血患者分为存活组194例,死亡组22例。分析急性上消化道出血患者血清LDH与D-LA水平的相关性,影响急性上消化道出血患者入院后30d内死亡的因素,血清LDH和D-LA水平对急性上消化道出血患者入院后30d内死亡的预测价值。结果:与对照组比较,试验组血清LDH、D-LA水平显著升高,差异有统计学意义(P<0.05);与存活组比较,死亡组AIMS65评分、血清LDH、D-LA水平显著升高,血红蛋白(Hb)水平显著降低,差异有统计学意义(P<0.05);急性上消化道出血患者血清LDH与D-LA水平呈正相关,差异有统计学意义(P<0.05);AIMS65评分高、高水平LDH、高水平D-LA均是影响急性上消化道出血患者入院后30d内死亡的独立危险因素,差异有统计学意义(P<0.05);血清LDH、D-LA、二者联合预测急性上消化道出血患者入院后30d内死亡的曲线下面积(AUC)分别为0.844、0.819、0.916,二者联合预测的AUC高于血清LDH、D-LA各自单独预测的AUC(P<0.05)。结论:急性上消化道出血患者血清LDH和D-LA水平升高,二者水平与患者预后密切相关,联合检测血清LDH和D-LA对患者预后有较高的预测价值。
Objective:To investigate the relationship between serum lactate dehydrogenase(LDH)and D-lactic acid(D-LA)levels in patients with acute upper gastrointestinal bleeding and their prognosis.Methods:A total of 216patients with acute upper gastrointestinal bleeding hospitalized in Handan People's Hospital from December 2018to January 2023were selected as the experimental group,and 132healthy persons were selected as the con-trol group.Clinical data,AIMS65score and biochemical indexes of patients with acute upper gastrointestinal bleeding were collected,and serum LDH and D-LA levels of the experimental group and control group were detec-ted.According to the survival within 30days after admission,patients with acute upper gastrointestinal bleeding were divided into survival group(194cases)and death group(22cases).Clinical data were analyzed,including the correlation between serum LDH and D-LA levels in patients with acute upper gastrointestinal bleeding,the factors affecting death within 30days after admission in patients with acute upper gastrointestinal bleeding,and the pre-dictive value of serum LDH and D-LA levels on death within 30days after admission in patients with acute upper gastrointestinal bleeding.Results:Compared with control group,serum LDH and D-LA levels in experimental group were significantly increased(P<0.05).Compared with survival group,AIMS65score,serum LDH and D-LA levels in death group were significantly increased,while hemoglobin(Hb)level was significantly decreased(P<0.05).Serum LDH was positively correlated with D-LA level in patients with acute upper gastrointestinal bleed-ing(P<0.05).High AIMS65score,high LDH level and high D-LA level were independent risk factors for death within 30days after admission in patients with acute upper gastrointestinal bleeding(P<0.05).The area under curve(AUC)of serum LDH,D-LA,and their combined prediction of death within 30days after admission in pa-tients with acute upper gastrointestinal bleeding were 0.844,0.819,and 0.916,respectively,and the AUC of combined prediction was higher than that of serum LDH and D-LA separately(P<0.05).Conclusion:Serum LDH and D-LA levels are elevated in patients with acute upper gastrointestinal hemorrhage,and the levels of both is closely related to patient prognosis,and the combined detection of serum LDH and D-LA has a high predictive value for patient prognosis.
作者
侯荣华
李延玲
程玲玲
沈勇
HOU Ronghua;LI Yanling;CHENG Lingling;SHEN Yong(Department of Gastroenterology,Handan People's Hospital,Handan,Hebei,056001,China;Department of Internal Medicine,the Hebei Armed Police Headquarters Hospital)
出处
《临床急诊杂志》
CAS
2023年第9期483-488,共6页
Journal of Clinical Emergency
基金
河北省医学科学研究课题计划项目(No:20220182)。
关键词
急性上消化道出血
乳酸脱氢酶
D-乳酸
预后
acute upper gastrointestinal bleeding
lactate dehydrogenase
D-lactic acid
prognosis
