摘要
目的：探讨重症脓毒血症患儿血乳酸水平及其对患儿临床预后的影响。方法选取重症脓毒血症患儿90例为研究对象，根据患儿的预后分为生存组、死亡组各45例，比较两组入院后不同时间点的血乳酸水平、血乳酸清除率、两组一般情况以及不同时间点纤维蛋白原、氧合指数以及 D-二聚体水平。结果治疗后，两组纤维蛋白原、氧合指数以及 D-二聚体水平均有所改善，生存组纤维蛋白原、D-二聚体水平[（2．71±0．31）ng／mL、（0．89±0．10）mg／L）]低于死亡组[（2．89±0．21）ng／mL、（1．26±0．18）mg／L）]，两组差异均有统计学意义（t ＝3．224，P ＝0．001；t ＝12．053，P ＝0．000）；生存组氧合指数[（196．23±14．69）mmHg）]高于死亡组[（180．23±21．03）mmHg）]，差异有统计学意义（t ＝4.184，P ＝0．000）；生存组 EGOT 达标率、APACHE Ⅱ评分以及 MODS 发生率均明显低于死亡组，两组差异均有统计学意义（t ＝7．200，P ＝0.007；t ＝9．149，P ＝0.000；t ＝29．298，P ＝0．000）；生存组入院后各时间点的血乳酸水平均显著低于死亡组，两组差异均有统计学意义（t ＝50．543，P ＝0．000；t ＝33．932，P ＝0．000；t ＝17．915，P ＝0．000；t ＝28．703，P ＝0．000）；生存组6 h、24 h 血乳酸清除率≥10％（73.33％、80．00％）均显著高于死亡组（37．78％、44．44％），两组差异均有统计学意义（χ2＝11．520，P ＝0.000；χ2＝12.100，P ＝0．000）。结论脓毒血症患儿的血乳酸水平是判断脓毒血症患儿预后和患儿病情严重程度的一个重要指标，对脓毒血症患儿的治疗具有指导意义。
Objective To investigate the change of blood lactate level in children with severe sepsis,and its relationship with clinical prognosis.Methods 90 children with severe sepsis who treated in our hospital from February 201 3 to May 201 4 were selected as the study subjects.According to the prognosis of children,they were divided into survival group and death group,45 cases in each group.The blood lactate levels at different time points, blood lactate clearance rates between the two groups at different time points as well as fibrin,oxygenation index and D -dimer levels were compared after admission.Results After treatment,the fibrin,oxygenation index and D -dimer levels in the two groups were improved.The fibrin and D -dimer levels in the survival group[（2.71 ±0.31 ）ng/mL, （0.89 ±0.1 0）mg/L）]were lower than those in the death group[（2.89 ±0.21 ）ng/mL,（1 .26 ±0.1 8）mg/L）],the differences were significant（t =3.224,P =0.001 ;t =1 2.053,P =0.000）.The oxygenation index of the survival group[（1 96.23 ±1 4.69）mmHg）]was higher than that of the death group [（1 80.23 ±21 .03 ）mmHg）],the difference was significant（t =4.1 84,P =0.000）.The EGOT compliance rate,APACHE Ⅱscore and MODS incidence rate of survival group were significantly lower than those of the death group,the differences were significant（t =7.200,P =0.007;t =9.1 49,P =0.000;t =29.298,P =0.000）.The blood lactate levels at each time points in the survival group were significantly lower than the death group,the differences were statistically significant（t =50.543, P =0.000;t =33.932,P =0.000;t =1 7.91 5,P =0.000;t =28.703,P =0.000）.The 6 h,24 h blood lactate clearance rates≥1 0% of the survival group （73.33%,80.00%）were significantly higher than those of the death group（37.78%,44.44%）,the differences were significant（χ2 =1 1 .520,P =0.000;χ2 =1 2.1 00,P =0.000）. Conclusion Lactate level in children with sepsis is an important indicator of prognosis in children with severe＆nbsp;sepsis,with guidanc
作者
罗玲玲
林应荣
潘丹峰
江金彪
Luo Lingling Lin Yingrong Pan Danfeng Jiang Jinbiao(Department of Pediatrics, the First People ~ Hospital of Wenling, Wenling, Zhejiang 317500, China)
出处
《中国基层医药》
CAS
2017年第1期64-67,共4页
Chinese Journal of Primary Medicine and Pharmacy
基金
浙江省温岭市科技局项目（2010WLCA0061）
关键词
脓毒症
乳酸
预后
Sepsis
Lactate acid
Prognosis
