Verma Indu, Kaur Satinder, Goyal Subash, Goyal Shweta, Multani J S, Narang A P S
Department of Biochemistry, Dayanand Medical College and Hospital, Ludhiana, Punjab India.
Department of Surgery, Dayanand Medical College and Hospital, Ludhiana, Punjab India.
Indian J Clin Biochem. 2014 Jul;29(3):382-5. doi: 10.1007/s12291-013-0385-1. Epub 2013 Sep 26.
The supply of oxygen is limited in certain intra abdominal conditions due to direct vascular invasion or inflammatory process, resulting in high lactate levels. Aim of this study was to find the predictive value of lactate levels in the peritoneal fluid (PF) and blood of patients with acute abdomen. The study comprised of fifty patients with acute abdominal conditions, admitted in emergency ward of tertiary care hospital, thirty patients were with surgical abdomen (group I) and twenty patients with non surgical abdomen (group II). Lactate was estimated in PF and blood on Blood Gas Analyzer (NOVA, M-7). The mean lactate levels in PF were significantly higher in group I as compared to group II (14.65 ± 1.195 vs. 5.92 ± 0.97 mmol/L, p < 0.001). There was no significant difference in blood lactate levels in both the groups. When PF and blood lactate levels were compared within groups, we found that PF levels were significantly higher than blood in group I (14.65 ± 1.195 vs. 3.85 ± 0.54 mmol/L, p < 0.001) but not in group II (5.92 ± 0.97 vs. 4.36 ± 0.95 mmol/L). Diagnostic value was obtained using ROC curve. Cut off values obtained for PF lactate, difference and ratio of PF and blood lactate (≥6.4 mmol/L, ≥3.3 and ≥2.1 respectively) are at very high degree of sensitivity and specificity. So it can be useful marker of surgical emergency in patients with acute intra abdominal pathology, especially in clinically ill patients or in whom physical examination is not yielding because of neurologic disorders or unresponsiveness.
在某些腹腔内疾病中，由于直接的血管侵犯或炎症过程，氧气供应受限，导致乳酸水平升高。本研究的目的是探讨乳酸水平对急腹症患者腹腔积液（PF）和血液的预测价值。该研究纳入了50例患有急腹症的患者，这些患者均入住三级护理医院的急诊病房，其中30例为外科急腹症患者（第一组），20例为非外科急腹症患者（第二组）。使用血气分析仪（NOVA，M - 7）测定PF和血液中的乳酸含量。第一组PF中的平均乳酸水平显著高于第二组（14.65 ± 1.195 vs. 5.92 ± 0.97 mmol/L，p < 0.001）。两组患者的血乳酸水平无显著差异。当比较组内PF和血乳酸水平时，我们发现第一组中PF水平显著高于血液（14.65 ± 1.195 vs. 3.85 ± 0.54 mmol/L，p < 0.001），而第二组中则不然（5.92 ± 0.97 vs. 4.36 ± 0.95 mmol/L）。使用ROC曲线获得诊断价值。PF乳酸、PF与血液乳酸的差值及比值的截断值（分别≥6.4 mmol/L、≥3.3和≥2.1）具有非常高的敏感性和特异性。因此，它可以作为急性腹腔内病变患者手术急症的有用标志物，尤其是在临床病情较重的患者或因神经系统疾病或无反应而体格检查无结果的患者中。
