急性脑梗死早期血乳酸变化的研究

目的探讨急性脑梗死(acute ischemic stroke,AIS)患者早期血乳酸的变化及其对诊断的意义。方法选择2011年4月—2013年3月我院收治的148例发病4.5 h内的AIS患者作为AIS组,另选择同期51例体检健康者作为对照组。AIS组于入院时、对照组于体检日采集静脉血检测血乳酸水平。比较两组血乳酸测定值,通过绘制受试者工作特征(ROC)曲线得出协助诊断的最佳截断值,并分析AIS组血乳酸测定值与美国国立卫生研究院卒中量表(NIHSS)评分的相关性。结果 AIS组入院时血乳酸为(2.09±0.75)mmol/L显著高于对照组的(1.65±0.53)mmol/L,差异有统计学意义(t=4.60,P=0.0001);用于协助诊断的最佳截断值为1.85 mmol/L;AIS组血乳酸水平与NIHSS评分无相关性(r=0.128,P=0.121)。结论血乳酸很可能是AIS的早期诊断标志物之一,血乳酸升高可能具有协助早期诊断AIS的临床价值。

Changes of Blood Lactic Acid in Acute Ischemic Stroke during Primary Period

Objective To study the changes of blood lactic acid in acute ischemic stroke （AIS） and its diagnostic val-ue. Methods A total of 148 AIS inpatients within 4. 5 h after onset during April 2011 and March 2013 were chosen as AIS group, and 51 volunteers taking health examination at the same period were as control group. The level of blood lactic acid was measured at once after admission in AIS group and the day receiving health examination in control group. The values of blood lactic acid was obtained by drawing receiver operating curve （ROC） in the two groups and were compared, and the best cutoff value assisting diagnosis and the relationship between value of blood lactic acid in AIS group with score of United States National Institutes of Health Stroke Scale （NIHSS） were also analyzed. Results The value of blood lactic acid （2. 09 ± 0. 75）mmol/ L in AIS group at once after admission was significantly increased, compared with （1. 65 ±0. 53）mmol/ L in control group （t =4. 60, P =0. 0 001）; the best cutoff value assisting diagnosis of blood lactic acid was 1. 85 mmol/ L; there was no relationship between value of blood lactic acid and NIHSS score （r =0. 128, P =0. 121）. Conclusion Blood lactic acid may be one of ear-ly biomarkers in diagnosis of acute ischemic stroke, and the increasing value may be helpful in diagnosis of acute ischemic stroke in primary period.