【摘要】 目的观察不同剂量持续性肾脏替代治疗(CRRT)对危重患者血乳酸(BLa)清除程度的影响。方法 24例危重患者根据BLa水平归入4组(A组:BLa<2 mmol/L;B组:2 mmol/L≤BLa<4 mmol/L;C组:4 mmol/L≤BLa<8 mmol/L;D组:BLa≥8 mmol/L),每组依次接受25、35、45 m L/(kg·h)剂量的CRRT,每次1 h。根据CRRT前后BLa浓度计算BLa清除率及清除量。结果同组中CRRT剂量越大,BLa清除率越大(P<0.05或0.01),但BLa清除量差异无统计学意义(P>0.05)。相同CRRT剂量时,各组BLa清除率差异无统计学意义(P>0.05),但C、D组BLa清除量明显大于A、B组(P<0.05或0.01)。结论 CRRT剂量影响危重患者BLa清除率,而初始BLa水平影响乳酸清除量。更多还原

【Abstract】 Objective To observe the impact of different doses of continuous renal replacement therapy(CRRT) on blood lactate(BLa) clearance in critical patients. Methods Twenty-four critical patients were categorized into 4 groups based on their BLa levels(Group A: BLa<2 mmol/L; Group B:2 mmol/L≤BLa<4 mmol/L; Group C:4 mmol/L≤BLa<8 mmol/L; Group D: BLa≥8 mmol/L). Each group received in turn 25,35,and 45 m L/(kg·h) of CRRT for 1 hour. The clearance rate and volume of BLa were calculated using BLa levels of pre- and post-CRRT. Results In the same group,BLa clearance rates were increased with CRRT doses(P<0.01 or 0.05),but BLa clearance volumes were not(P>0.05). In the same CRRT dose,BLa clearance rates were similar among all groups(P>0.05),whereas BLa clearance volumes were higher in Groups C and D than in Groups A and B(P<0.01 or 0.05). Conclusion The BLa clearance rates and volumes can be dependent on the CRRT doses and initial BLa contents,respectively.更多还原