乳酸分析在临床中的应用培训课件.ppt

1、葡萄糖蛋白质脂肪10/7/2022 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10/7/2022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10/7/202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/

2、202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/2022Jan B,Philippe G,Michel C,et al.Serial blood lactate levels can predict the development of multiple organ failure following septic shock J.Am J Surg,1996,171(2):221-226 Henning R J，Wei M N Weiner F.Blood lactate as a prognostic indic

3、ator of survivial in patients with acute myocardial infarction.Circ Shock,1982,9(3):30710/7/2022Rashkin MC,Bosken C,Baughman RP.Oxygen delivery in critically ill patients:Relationship to blood lactate and survival.Chest,1985,87(5):58010/7/202210/7/202210/7/202210/7/202210/7/202210/7/2022J Inflamm(Lo

4、nd)2010;7:610/7/202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/2022Munoz 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 morbi

5、dity and mortalityJ Thorac Cardiovasc Surg,2000,119：155一162.心内直视手术病人的乳酸监测10/7/202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/202210/7/2022付利民等 ：实用儿科临床杂志2004，19（7），576578 10/7/2022Kruger K,Hallberg B,Blennow M,et al.Predictive value of fetal scalp blood lactate conce

6、ntration and pH as markers of neurologic disabilityJ.Am J Obstet Gynecol,1999，181:1072-1078.围产儿的乳酸监测10/7/202210/7/202210/7/2022Mathieu Gatien,MD Ian Stiell,MD,et al.Diagnostic Performance of Venous Lactate on Arrival at the Emergency Department for Myocardial Infarction.Academic Emergency Medicine.2

7、005 12(2):106-11310/7/202210/7/202210/7/202210/7/202210/7/202210/7/2022Coast TJ,Smith JE,Lockey D,et al.Early increase in blood lactate following injuryJ.JR Army Med Corps,2002,148(2):140-14310/7/2022夏红杰 王 洁 现代医药卫生2004年第8期10/7/202210/7/202210/7/202210/7/20221 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

8、华急诊医学杂志，2005，14（4）:313-31510/7/2022线粒体结构模式图10/7/2022齐多夫定(zidovudine)和司他夫定(stavudine)10/7/202210/7/202210/7/202210/7/2022Astles 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 C

9、linical Chemistry,3rd ed.Burtis CA,Ashwood ER,Eds.Philadelphia,Saunders,1999,pp787-789 10/7/202210/7/202210/7/202210/7/202210/7/2022GEM Premier 3000pH,PCO2,PO2,Hct,Na,K,Ca,Glu,Lac10/7/202210/7/2022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）10/7/2022

10、性能可靠 多年的临床应用经验10/7/202210/7/2022iQM一体化分析包10/7/202210/7/2022THb,O2Hb,CO2Hb,MetHb(plus cO2sat and O2cont)PT,APTT,ACT,ACT-LR10/7/2022操作简便、免维护灵活的检测项目组合是IL的经典之作10/7/202210/7/2022 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 SO210/7/202293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，臂非加长也，而见者远；登高而招，臂非加长也，而见者远；顺风而呼，声非加疾也，而闻者彰。顺风而呼，声非加疾也，而闻者彰。假舆马者，非利足也，而致千里；假舆马者，非利足也，而致千里；假舟楫者，非能水也，而绝江河。假舟楫者，非能水也，而绝江河。10/7/2022谢谢！10/7/2022