摘要
[目的]评估血清乳酸（LAC）监测对危重病人的临床诊断价值.[方法]选择78例本院ICU病房的资料完整的危重症患者作为对象进行回顾性研究.利用东芝TBA-120FR检测研究对象的血清LAC.78例患者按不同的LAC结果分成4组（即血乳酸正常组、血乳酸轻度增高组、血乳酸中度增高组和血乳酸高度增高组）,并结合APACHEⅡ评分对其病情状况进行评估.[结果]4组血乳酸值由低到高分别为1.22±0.45、2.94±0.86、6.82±1.46和9.64±1.82 mmol/L.随着血清LAC浓度的升高,患者病死率亦随之升高 （从12.5%升至73.3%）,生存组的血乳酸水平显著高于死亡组（P＜0.01）;血乳酸重度增高组的APACHEⅡ评分与血乳酸正常组比较差异有显著性（P＜0.05）,而血乳酸轻、中度增高组的APACHEⅡ评分与血乳酸正常组比较差异无显著性（P＞0.05）,危重症患者的血乳酸水平与APACHEⅡ评分呈明显正相关.[结论]血乳酸的动态监测是评估危重症患者病情严重程度及预后的一个简单、实用、有效的指标.
[Objective] To evaluate the clinical value of the monitoring of serum lactic acid（LAC） level in critical illness patients. [Methods] Totally 78 critical illness patients with complete data in ICU of our hospital were selected as the research objects for the retrospective study. Serum LAC level of all research objects were measured by using TBA-120FR. According to the results of LAC, all 78 patients were divided into four groups including normal group, mildly increased group, moderately increased group and highly increased group of serum LAC. The patients＇ condition was assessed by APACHE II score. [Results] Serum LAC levels in four groups were 1.22±0.45, 2. 94±0.86, 6. 82±1.46 and 9.64±1.82mmol/L, respectively from low to high. With the increasing of serum LAC level, the mortality of patients increased（from 12.5% to 73.3%）. Serum LAC level of the survival group was obviously higher than that of the death group, and there was significant difference between two groups（ P 〈0.01）. The APACHE II score of the highly increased group was obviously higher than that of the normal group （ P 〈0.05）. There was no significant difference in APACHE II score between the mildly and moderately increased groups and normal group（ P 〉0.05）. Serum LAC level in critical illness patients was positively related to APACHE II score. [Conclusion] .The dynamic monitoring of serum LAC level is a simple, practical and effective index for assessing the severity of the illness and the prognosis of critical illness patients.
出处
《医学临床研究》
CAS
2011年第12期2316-2318,共3页
Journal of Clinical Research
