摘要
目的探讨乳酸代谢及乳酸清除率对重症中暑患者预后的评估价值。方法选择本院68例重症中暑患者,入科时测定动脉血乳酸,治疗6 h后再测定动脉血乳酸,计算乳酸清除率。同时以动脉血乳酸清除率10%为界限,分为高乳酸清除率组（≥10%）和低乳酸清除率组（〈10%）,分析2组APACEHⅡ评分、ICU住院时间、总住院时间、死亡率的差异。结果按乳酸水平分层（〈2 mmol/L;≥2~〈4 mmol/L;≥4~〈10 mmol/L;≥10 mmol/L）,其对应的死亡率分别为0%,0%,14.29%,66.77%。高乳酸清除率组和低乳酸清除率组间乳酸水平、APACHEⅡ评分、总住院时间等无显著差异,但高乳酸清除率组ICU住院时间明显缩短,死亡率低。乳酸水平与APACEHⅡ评分呈正相关（r=0.508,P=0.000）,乳酸清除率与ICU住院时间呈负相关（r=-0.422,P=0.01）。结论动态监测乳酸及乳酸清除率对重症中暑患者具有重要价值,对评价病情变化趋势及判断预后有指导意义。
Objective To investigate the clinical value of serum lactate metabolism and lactate clearance rate in the prognosis evaluation of patients with the severe heart stroke. Methods A total of 68 severe heart stroke patients were collected. Arterial blood lactate was detected on admission and 6 hours after treatment respectively,and lactate clearance rate was calculated. Taking the 10%lactate clearance rate as the boundary,all the patients were divided into high lactate clearance rate group（ ≥10%） and low lactate clearance rate group（ 10%）. The mortality of patients with different lactate levels,score of APACHE Ⅱ,days in ICU and total hospital stay were analyzed. Results The mortality rates of patients with different serum 1actate levels（ 2 mmol / L,≥2 ~ 4 mmol / L,≥4 ~ 10 mmol/L,≥10 mmol/L） were 0%,0%,14. 29% and 66. 77% respectively. There were no significant differences in serum lactate level,APACHE Ⅱ score and total hospital stay between two groups,but the days in ICU of high lactate clearance rate group shortened significantly and mortality rate reduced. Serum lactate level was positively correlated with APACHE II score（ r = 0. 508,P = 0.00）,and lactate clearance rate was negatively correlated with days in ICU（ r =- 0. 422,P = 0. 01）.Conclusion Dynamic monitoring of lactate level and lactate clearance rate shows a predictive value for prognosis in patient with severe heart stroke
出处
《实用临床医药杂志》
CAS
2015年第23期44-47,共4页
Journal of Clinical Medicine in Practice
关键词
血乳酸
6
h乳酸清除率
重症中暑
blood lactic acid
6 hours of lactic acid clearance rate
severe heat stroke
