乙醇和乳酸盐:有没有直接的关联?
Megan Audette1, Damilola Idowu1, Amy Zosel1
1Department of Emergency Medicine, Division of Medical Toxicology, Medical College of Wisconsin, Milwaukee, WI, USA.
乙醇中毒患者血清乳酸水平升高并不是直接由酒精引起的. 这项研究没有发现显著的相关性,表明当乳酸水平高时,应该研究其他因素.
科学领域:
- 紧急医疗 紧急医疗
- 临床化学 临床化学
- 毒理学 毒理学 毒理学
背景情况:
- 乙醇中毒在急诊室 (ED) 很常见.
- 血清乳酸是疾病严重程度的生物标志物,可能在急性乙醇中毒中因改变的氧化还原状态而升高.
- 在中毒患者中,由于解释不确定性,乳酸盐测试可能会被推迟,这种关系没有量化.
研究的目的:
- 调查成人患者血清乙醇和乳酸盐度之间的相关性.
- 确定是否仅仅是乙醇中毒是乳酸水平升高的重要原因.
- 在乙醇中毒患者中进行乳酸盐测试的临床实践中提供信息.
主要方法:
- 对两个成年患者队列 (学术卫生系统和退伍军人卫生管理局) 的回顾性研究.
- 在ED遭遇期间测量了血清乙醇水平.
- 患有与乳酸性酸相关的疾病或药物患者被排除在外;进行回归分析.
主要成果:
- 在学术中心 (r2 = 0.00110) 和VHA (r = -0.00019,P = 0.9899) 队列中,乙醇和乳酸盐度之间的相关性很差.
- 高乙醇度 (>80 mg/dL和>200 mg/dL) 的亚组分析也显示了差的相关性.
- 在乙醇度和乳酸盐度之间没有发现显著的关系.
结论:
- 乙醇中毒患者乳酸盐水平升高不应仅仅归因于饮酒.
- 基于疑似乙醇中毒,推迟乳酸测试的临床决定没有得到这些数据的支持.
- 在中毒患者中,需要进一步调查乳酸水平升高的其他原因.
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