摘要
目的 探讨血乳酸、乳酸清除率和氧合指数在重症脓毒症患者预后评估中的临床价值.方法 选择46例因重症脓毒症入住ICU的患者,按照28d预后分为生存组和死亡组.比较两组血乳酸浓度、乳酸清除率、氧合指数和急性生理与慢性健康状况（APACHEⅡ）评分,并建立ROC曲线.结果 乳酸、乳酸清除率、氧合指数和APACHEⅡ评分在两组患者中差异均有统计学意义（P＜0.05或0.01）,乳酸、乳酸清除率、氧合指数与APACHEⅡ评分存在明显正相关（r=0.932,P=0.012）.乳酸、乳酸清除率、氧合指数阳性项目越多,28d病死率越高.乳酸、乳酸清除率、氧合指数和APACHEⅡ评分的ROC曲线下面积分别为0.715、0.744、0.701、0.759.结论 血乳酸浓度、乳酸清除率和氧合指数与APACHEⅡ评分显著相关,可以预测重症脓毒症患者的预后.
Objective To investigate the value of blood lactic acid, lactic acid clearance and oxygenation index in prog- nosis of patients with severe sepsis. Methods Forty-six patients were divided into survival group and death group according to their outcome. Levels of blood lactic acid, lactic acid clearance and oxygenation index were measured, and acute physiology and chronic health evaluation （APACHE Ⅱ） was scored. ROC was constructed to observe the clinical value of blood lactic acid, lactic acid clearance, oxygenation index and APACHE Ⅱ on prognosis of severe sepsis. Results There were significant differences in the levels of blood lactic acid, lactic acid clearance, oxygenation index and APACHE Ⅱ score between two groups. Blood lactic acid, lactic acid clearance and oxygenation index were significantly correlated with APACHE Ⅱ score. The presence of more pos- itive biomarkers, the higher 28-d mortality was. The area under the curve（AUC） in ROC of blood lactic acid, lactic acid clearance, oxygenation index and APACHE Ⅱ score were 0.715, 0.744, 0.701 and 0.759. Conclusion Blood lactic acid, lactic acid clearance and oxygenation index are correlated with APACHE Ⅱ, and can be used for prognosis of patients with severe sepsis.
出处
《浙江医学》
CAS
2012年第9期700-701,704,共3页
Zhejiang Medical Journal
基金
浙江省医药卫生科学研究基金资助项目（2009A017）
关键词
重症脓毒症
血乳酸
乳酸清除率
氧合指数
APACHEⅡ
Severe sepsis Lactic acid Lactate clearance rate Oxygenation index Acute physiology and chronic health evaluation
