中国体外生命支持2026，Vol.24Issue(1)：1-7,7.DOI:10.13498/j.cnki.chin.j.ecls.2026.01.01
儿童心脏移植术中乳酸变化轨迹与临床预后的关系:基于组基轨迹模型分析
Intraoperative Lactate Trajectories and Clinical Outcomes in Pediatric Heart Transplantation:an Analysis Based on Group-Based Trajectory Modeling
摘要
Abstract
Objective To analyze the changes in intraoperative lactate levels in pediatric heart transplant patients and their impact on prognosis.Methods We retrospectively collected clinical data of pediatric heart transplant patients in the Department of Cardiac Surgery,Guangdong Provincial People's Hospital,from January 2018 to December 2023.Patients were divided into the survival group(n=39)and the death group(n=5)according to their status at discharge.Demographic characteristics,laboratory indicators,surgical parameters,and postoperative hospital stay were compared between the two groups.Repeated-measures ANOVA and group-based trajectory modeling(GBTM)were used to assess the effect of intraoperative lactate patterns on prognosis.Results A total of 44 children undergoing heart transplantation were included,of whom 5(11.36%)died after surgery and before discharge.Repeated measures ANOVA showed that lactate levels changed over time(F=10.424,P<0.001),with significant differences between groups(F=79.588,P<0.001),but the interaction between group and time was not statistically significant(F=1.354,P=0.234).GBTM identified two intraoperative lactate trajectories:high-level rapid increase and low-level slow increase.Patients with the low-level slow increase trajectory had a significantly lower risk of death than those with the high-level rapid increase trajectory,HR=0.588,P=0.034.Conclusion Pediatric heart transplant patients with a high-level rapid increase in intraoperative lactate had a worse prognosis.Early identification of high-risk lactate trajectories may help improve patient management and guide treatment strategies.关键词
儿童心脏移植/术中/乳酸/轨迹模型/预后Key words
pediatric heart transplantation/intraoperative/lactate/trajectory model/prognosis引用本文复制引用
苏泉林,周成斌,全梓林,李天宝,林中林,雷迪斯,罗智超,彭东,吴敏,黄劲松..儿童心脏移植术中乳酸变化轨迹与临床预后的关系:基于组基轨迹模型分析[J].中国体外生命支持,2026,24(1):1-7,7.基金项目
国家重点研发计划(2023YFC2410305) （2023YFC2410305）
