摘要
目的探讨乳酸清除率(LCR)与脑利钠肽(BNP)的动态变化评估肝胆外科患者脓毒血症预后的临床意义,为治疗提供参考依据。方法选取2012年6月-2015年6月医院肝胆外科ICU确诊为脓毒血症患者64例,根据诊断脓毒血症后28天的生存状况分为死亡组43例和存活组21例;分析两组患者第1、3、5天LCR、BNP和急性生理与APACHEⅡ评分的动态变化,评估LCR及BNP对患者预后评估的临床意义。结果与生存组患者相比,死亡组患者在诊断脓毒血症后第1天LCR、BNP及APACHEⅡ评分差异均无统计学意义;第3、5天LCR、BNP差异及第5天APACHEⅡ评分差异有统计学意义(P<0.05)。结论肝胆外科脓毒血症患者LCR及BNP的动态变化与病情密切相关,与APACHEⅡ评分联合对患者的预后具有临床指导意义。
OBJECTIVE To evaluate the value of dynamic variation of lactate clearance rate（LCR）and brain natriuretic peptide（BNP）in predicting the prognosis of sepsis patients,so as to provide reference for treatment.METHODS A total of 64 sepsis patients were enrolled in the study since the sepsis diagnosis were made in department of hepatobiliary surgery ICU of PLA general hospital from Jun.2012 to Jun.2015 and patients were assigned into death group（n=43）and survival group（n=21）according to their 28 day survival status.their values of LCR,BNP and APACHEⅡsystem score were measured on day 1,3and 5after sepsis diagnosis were confirmed,the LCR and BNP were under evaluation for the meaning of them to patients prognosis.RESULTS Values of LCR,BNP and APACHEⅡsystem score on day 1in survival group were no significant difference comparing with death group.However,the level of LCR and BNP on day3 and day5and APACHEⅡsystem score on day 5were significantly higher in survival group than in the death group（P〈0.05）.CONCLUSION The dynamic level of LCR and BNP are correlative closely with the severity of sepsis in hepatobiliary surgery.Combined detection of LCR and BNP with APACHEⅡsystem score can be used to evaluate the condition of patients with sepsis as well as the prognosis of the disease.
作者
马焕先
史宪杰
梁雨荣
史海达
王鹤
赵永生
MA Huan-xian SHI Xian-jie LIANG Yu-rong SHI Hai-da WANG He ZHAO Yong-sheng(PLA General Hospital, Beijing 100853, China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第23期5398-5400,共3页
Chinese Journal of Nosocomiology
基金
军队"十二五"课题面上项目(CWS11J096)
