乳酸分析在临床中的应用

1、沃芬医疗 张浩葡萄糖蛋白质脂肪 葡萄糖的代谢产物能量单位(ATP)反应地点有氧代谢水+二氧化碳36线粒体内无氧代谢乳酸2线粒体外线粒体结构模式图细胞浆细胞浆糖元糖元-葡萄糖葡萄糖-丙酮酸丙酮酸 2ATP 乳酸乳酸无氧糖酵解无氧糖酵解有氧糖酵解有氧糖酵解线粒体线粒体O2 CO2 H2O 36ATP三羧酸循环三羧酸循环Jan B,Philippe G, Michel C,et al. Serial blood lactate levels can predict the development of multiple organ failure following septic shock J.A

2、m J Surg,1996,171(2):221-226 Henning R J，Wei M N Weiner F. Blood lactate as a prognostic indicator of survivial in patients with acute myocardial infarction.Circ Shock,1982,9(3):307Rashkin MC,Bosken C, Baughman RP. Oxygen delivery in critically ill patients :Relationship to blood lactate and surviva

3、l. Chest,1985,87(5):580J Inflamm(Lond) 2010;7:6Munoz R,Laussen PC, Palacio G, et al.Changes in whole bloodlactate levels during cardiopulmonary bypass for surgery for congenital cardiac disease an early indicator of morbidity and mortalityJ Thorac Cardiovasc Surg,2000,119：155一162. 心内直视手术病人的乳酸监测付利民等

4、：实用儿科临床杂志2004，19（7），576578 Kruger K, Hallberg B, Blennow M, et al. Predictive value of fetal scalp blood lactate concentration and pH as markers of neurologic disabilityJ. Am J Obstet Gynecol,1999，181:1072-1078.围产儿的乳酸监测Mathieu Gatien,MD Ian Stiell,MD,et al.Diagnostic Performance of Venous Lactate on

5、 Arrival at the Emergency Department for Myocardial Infarction. Academic Emergency Medicine.2005 12(2):106-113Coast TJ,Smith JE, Lockey D,et al.Early increase in blood lactate following injuryJ.JR Army Med Corps,2002,148(2):140-143夏红杰 王 洁 现代医药卫生2004年第8期1 李春盛，顾伟等。充血性心力衰竭患者循环内皮细胞、血乳酸和一氧化氮浓度的变化J。中华急诊医学

6、杂志，2005，14（4）:313-315线粒体结构模式图齐多夫定(zidovudine)和司他夫定(stavudine)Astles R, Williams CP, Sedor F. Stability of plasma lactate in vitro in the Presence of antiglycolytic agents.Clin Chem 1994,40:1327-1330 Sacks DB. Carbohydrates. In Tietz Textbook of Clinical Chemistry,3rd ed.Burtis CA, Ashwood ER,Eds. Ph

7、iladelphia, Saunders, 1999,pp787-789 GEM Premier 3000pH, PCO2, PO2, Hct, Na, K, Ca, Glu, Lac第一台 pH/血气分析仪 1959 IL105血氧定量计1967 - IL182将动脉血气分析仪引入常规的临床检测发明了第一台血氧定量计用火焰光度计来测量电解质实现智能质量控制管理（iQM） 性能可靠 多年的临床应用经验iQM一体化分析包THb, O2Hb, CO2Hb, MetHb(plus cO2sat and O2cont)PT, APTT, ACT, ACT-LR操作简便、免维护灵活的检测项目组合是IL的经典之作 Ca+(7.4)* HCO3- HCO3std TCO2 BEecf BE(B) SO2c THbc O2ct O2cap A-aDO2 pAO2 paO2/pAO2 RI CaO2 CvO2 CcO2 a-vDO2 Qsp/ Qt P50BP(mmHG) 760BE & Temp-corrected Equations NCCLSP50 Calculation Parameter SO294君子生非异也，善假于物也。君子生非异也，善假于物也。登高而招