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目的:探讨中心静脉-动脉血二氧化碳分压差(Pcv-aCO_2)在评估急性心肌梗死后心源性休克严重程度及预后的价值。方法:回顾性分析2012-10-2014-12我院ICU收治的急性心肌梗死后心源性休克患者40例,根据入院时Pcv-aCO_2是否≥6mmHg(1mmHg=0.133kPa),将患者分为高Pcv-aCO_2组和低Pcv-aCO_2组。比较高Pcv-aCO_2组与低Pcv-aCO_2组之间相关数值的差异。结果:本研究显示2组患者入院时APACHEⅡ评分比较差异无统计学意义(P>0.05),具有可比性。在ScvO_2≥70%时,高Pcv-aCO_2组血乳酸(Lac)水平高于低PcvaCO2组。低Pcv-aCO_2组患者上呼吸机及主动脉内球囊反搏(IABP)时间、ICU住院时间均短于高Pcv-aCO_2组,且肾功能衰竭发生率低于高Pcv-aCO_2,差异有统计学意义(P<0.05)。2组患者炎性指标均有升高,差异无统计学意义(P>0.05)。结论:Pcv-aCO_2可用于早期评价急性心肌梗死后心源性休克严重程度及预后。
Objective: To investigate the value of central venous-arterial partial pressure of carbon dioxide (Pcv-aCO_2) in assessing the severity and prognosis of cardiogenic shock after acute myocardial infarction. Methods: Forty patients with cardiogenic shock after acute myocardial infarction admitted to ICU of our hospital from 2012-10-2014-12 were retrospectively analyzed. According to whether Pcv-aCO 2 ≥6mmHg (1mmHg = 0.133kPa) on admission, the patients were divided into high Pcv-aCO 2 group and low Pcv-aCO 2 group. The difference between Pcv-aCO 2 group and low Pcv-aCO 2 group was significant. Results: This study showed that there was no significant difference in APACHEⅡscore between the two groups (P> 0.05), which was comparable. When ScvO_2≥70%, the level of Lac in high Pcv-aCO_2 group was higher than that in low PcvaCO2 group. In low-Pcv-aCO 2 group, the duration of upper respiratory and intra-aortic balloon pump (IABP) and ICU stay in hospital were shorter than those in high-Pcv-aCO 2 group, and the incidence of renal failure was lower than that of high Pcv-aCO 2 Significance (P <0.05). Inflammatory markers in both groups were increased, the difference was not statistically significant (P> 0.05). Conclusions: Pcv-aCO 2 can be used to evaluate the severity and prognosis of cardiogenic shock after acute myocardial infarction.