摘要
目的探究血乳酸对2型糖尿病相关脓毒症患者预后的影响。方法选取2017年6月至2020年6月该院收治的132例2型糖尿病相关脓毒症患者作为研究对象,于入院即时、6 h、24 h和48 h测定患者动脉血乳酸水平,依据入院即时动脉血乳酸水平将患者分为正常组(血乳酸<2.4 mmol/L,n=58)和升高组(血乳酸≥2.4 mmol/L,n=74),比较两组患者出院后6个月预后情况。依据出院后6个月内是否死亡将患者分为存活组(n=86)和死亡组(n=46),比较两组患者不同时刻血乳酸水平,并应用受试者工作特征(ROC)曲线分析血乳酸水平对脓毒症患者预后的预测价值。结果入院24 h时,血乳酸正常组急性生理学和慢性健康状况评分(APACHEⅡ评分)低于升高组,正常组患者出院后6个月休克、多器官功能障碍综合征和死亡发生率低于升高组,差异均有统计学意义(P<0.05)。存活组患者入院即时、6 h、24 h和48 h的血乳酸水平均低于死亡组患者,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,入院24 h血乳酸和入院即时与治疗6 h的血乳酸差值均对脓毒症患者的预后有较高的预测价值,曲线下面积分别为0.847、0.761。结论2型糖尿病相关脓毒症患者的入院24 h血乳酸水平越高,患者预后越差,血乳酸水平可作为判断脓毒症患者6个月生存状况的重要指标。
Objective To explore the effect of blood lactic acid on prognosis of patients with type 2 diabetes-related sepsis.Methods A total of 132 patients with type 2 diabetes-related sepsis admitted in this hospital from June 2017 to June 2020 were selected as the research subjects,the arterial blood lactic acid level was measured immediately,6 h,24 h and 48 h,patients were divided into normal group(blood lactic acid<2.4 mmol/L,n=58) and elevated group(blood lactic acid ≥2.4 mmol/L,n=74) according to the arterial blood lactic acid level at the time of admission,the 6-month prognosis of the two groups was compared.They were divided into survival group(n=86) and death group(n=46) according to whether the patients died within 6 months or not,the blood lactic acid levels of the two groups of patients at different times were compared,and the blood lactic acid level was used to analyze the prognosis of sepsis patients by ROC curve.Results At 24 h after admission,the acute physiology and chronic health assessment Ⅱ(APACHE Ⅱ) scores of normal group was significantly lower than that of elevated group.And the incidence of shock,multiple organ dysfunction syndrome and death in the normal group were lower than those in the elevated group within 6 months(P<0.05).The blood lactic acid levels of patients in the surviving group at the time of admission,6 h,24 h and 48 h were lower than those in the death group,the differences were statistically significant(P<0.05).ROC curve analysis showed that serum lactic acid at 24 h on admission and the difference between immediate admission and 6 h of treatment for blood lactic acid had high predictive value for the prognosis of sepsis patients,and the AUC were 0.847 and 0.761,respectively.Conclusion The higher the level of 24 h blood lactic acid in patient with type 2 diabetes-related sepsis,the worse the prognosis.Blood lactic acid level could be used as an important indicator to judge the 6-month survival status of sepsis patients.
作者
罗勇
王伟
张鑫
张彦鹏
孙亮
顾大勇
LUO Yong;WANG Wei;ZHANG Xin;ZHANG Yanpeng;SUN Liang;GU Dayong(Department of Clinical Laboratory,Shenzhen Second People′s Hospital/the First Affiliated Hospital of Shenzhen University,Shenzhen,Guangdong 518035,China)
出处
《检验医学与临床》
CAS
2022年第10期1357-1359,1363,共4页
Laboratory Medicine and Clinic
关键词
2型糖尿病
脓毒症
血乳酸
生存状况
type 2 diabetes
sepsis
blood lactic acid
survival status
