摘要
目的探讨早期乳酸清除率对重症监护室(ICU)重症感染者治疗及预后的评估价值。方法选择ICU重症感染者152例,根据入院14 d后转归情况,分为存活组和死亡组,观察2组一般资料和入ICU即刻、治疗6 h、24 h临床指标。根据早期乳酸清除率,将患者分为高清除率组和低清除率组,比较2组一般资料及临床指标,并分析不同程度乳酸清除率与脓毒症休克发生率、死亡率的相关性。结果存活组脓毒症休克发生率显著低于死亡组(P<0.01),6 h及24 h乳酸清除率均高于死亡组(P<0.05或P<0.01)。随时间增加,存活组急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分降低,死亡组升高,2组比较差异显著(P<0.01)。高清除率组脓毒症休克发生率及死亡率均低于低清除率组,差异有统计学意义(P<0.05或P<0.01)。不同程度乳酸清除率与脓毒症休克发生率、死亡率均呈显著负相关(r=-3.622、-5.458,P<0.01)。结论早期乳酸清除率可作为评估ICU重症感染者预后的敏感指标。
Objective To explore the value of early clearance rate of lactic acid in evaluating the prognosis of patients with severe infection in Intensive Care Unit（ ICU）. Methods A total of 152 patients with severe infection in ICU were divided into survival group and dead group according to the prognosis 14 d after hospitalization,and the general data and clinical indexes of immediately- hospitalized ICU,6- h as well as 24- h treatment were all observed in both groups. According to early clearance rate of lactic acid,the patients were divided into high- and low- clearance rate groups,the general data and clinical indexes were observed,and the correlations between different degrees of clearance rate of lactic acid and incidence of septic shock as well as mortality were analyzed. Results The incidence of septic shock in survival group was dramatically lower than in dead group（ P〈0.01）,6- h and 24- h clearance rates of lactic acid higher than in dead group（ P〈0. 05 or P〈0.01）. As time went on,acute physiology and chronic health evaluation Ⅱ（ APACHE Ⅱ） scores went down in survival group,while up in dead group. Significant difference was presented between two groups（ P〈0. 01）. Both incidence of septic shock and mortality in high- clearance rate group were lower than in low- clearance rate group,with statistical significance（ P〈0. 05 or P〈0. 01）. Different degrees of clearance rate of lactic acid had significantly negative correlations with incidence of septic shock and mortality（ r =- 3. 622,- 5. 458,P〈0. 01）. Conclusion Early clearance rate of lactic acid can be used as a sensitive index in evaluating the prognosis of patients with severe infection in ICU.
出处
《实用临床医药杂志》
CAS
2015年第23期48-50,58,共4页
Journal of Clinical Medicine in Practice
基金
中国高校医学期刊临床专项资金(11522683)
关键词
早期乳酸清除率
重症监护室
重症感染
脓毒症休克
预后
early clearance rate of lactic acid
Intensive Care Unit
severe infection
septic shock
prognosis
