摘要
目的:动态观察血乳酸及D-二聚体水平对75岁以上高龄重症患者预后的评估价值。方法:分析126例75岁以上老年重症患者,分为病情改善的存活组与预后不良的死亡组,动态监测并比较患者入室1周内血乳酸及D-二聚体水平。结果:存活组55例,入室时急性生理与慢性健康状况(APACHEⅡ)评分平均(18.8±4.5)分,血乳酸平均(1.7±1.3)mmol/L,D-二聚体(2.03±1.55)mg/L;死亡组71例,入室时APACHEⅡ评分平均(25.3±6.8)分,血乳酸水平(2.4±1.6)mmol/L,D-二聚体(2.36±1.07)mg/L,入室时仅APACHEⅡ评分组间有显著差异;但入室1周时存活组血乳酸平均值(1.2±0.6)mmol/L,D-二聚体(2.05±0.81)mg/L;死亡组血乳酸平均值(5.6±4.4)mmol/L,D-二聚体(3.19±1.68)mg/L,均较存活组明显升高。结论:对老年重症患者动态监测血乳酸与D-二聚体水平对其预后有重要评估价值,1周内乳酸与D-二聚体水平持续下降者预后相对较好。
Objective：To evaluate the prognosis of senile critical patients over 75 years old by continuous monitoring blood lactic acid and D-dimer. Methods：One hundred and twenty-six critical patients over 75 years old were included in this research,and divided into two groups：improved surviving group and poor prognostic death group. Blood lactic acid and D-dimer were continuously monitored for the first week at admission into ICU. Results：Of 55 cases in the surviving group,APACHE II score was 18.8 ± 4.5 at admission in ICU,meanwhile lactic acid was （1.7 ± 1.3） mmol/L,and D-dimer was （2.03 ± 1.55） mg/L. Of 71 cases in the death group,APACHEⅡ score at admission was 25.3 ± 6.8,lactic acid was （2.4 ± 1.6） mmol/L,and D-dimer was （2.36 ± 1.07） mg/L. At admission,only APACHEⅡ score in the death group was significantly higher than that in the surviving group. After a week stay in ICU,lactic acid was （1.2 ± 0.6） and （5.6 ± 4.4） mmol/L,D-dimer was （2.05 ± 0.81） mg/L and （3.19 ± 1.68） mg/L in the surviving and the death group, respectively. Both indicators were significantly higher in the death group. Conclusion：Continuously monitored lactic acid and D-dimer were important indicators to evaluate the clinical prognosis of senile patients. The prognosis would usually be better if both lactic acid and D-dimer keep decreasing during the first week at admission in ICU.
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2013年第11期1541-1543,共3页
Journal of Nanjing Medical University(Natural Sciences)
基金
国家自然科学基金青年基金资助(81200196)
关键词
高龄
重症
预后
乳酸
D-二聚体
senile
critic
prognosis
lactic acid
D-dimer
