张博, 丁开方, 杨东星, 顾庆, 王路娥. 乳酸清除率联合心肌坏死标志物在感染性休克患者预后判断中的临床价值[J]. 蚌埠医科大学学报, 2017, 42(2): 191-194. DOI: 10.13898/j.cnki.issn.1000-2200.2017.02.017
    引用本文: 张博, 丁开方, 杨东星, 顾庆, 王路娥. 乳酸清除率联合心肌坏死标志物在感染性休克患者预后判断中的临床价值[J]. 蚌埠医科大学学报, 2017, 42(2): 191-194. DOI: 10.13898/j.cnki.issn.1000-2200.2017.02.017
    ZHANG Bo, DING Kai-fang, YANG Dong-xing, GU Qing, WANG Lu-e. The value of the lactate clearance rate combined with myocardial necrosis markers levels in predicting the prognosis of patients with septic shock[J]. Journal of Bengbu Medical University, 2017, 42(2): 191-194. DOI: 10.13898/j.cnki.issn.1000-2200.2017.02.017
    Citation: ZHANG Bo, DING Kai-fang, YANG Dong-xing, GU Qing, WANG Lu-e. The value of the lactate clearance rate combined with myocardial necrosis markers levels in predicting the prognosis of patients with septic shock[J]. Journal of Bengbu Medical University, 2017, 42(2): 191-194. DOI: 10.13898/j.cnki.issn.1000-2200.2017.02.017

    乳酸清除率联合心肌坏死标志物在感染性休克患者预后判断中的临床价值

    The value of the lactate clearance rate combined with myocardial necrosis markers levels in predicting the prognosis of patients with septic shock

    • 摘要: 目的:探讨乳酸清除率联合心肌坏死标志物在感染性休克患者预后判断中的临床价值。方法:158例感染性休克患者中126例患者6 h复苏治疗达到预期早期目标导向治疗目标。患者入院采血,测定乳酸清除率和心肌损伤标志物水平,并于治疗6 h和24 h取血检测乳酸清除率水平。分析乳酸清除率及心肌损伤标志物肌钙蛋白T(cTnT)、肌红蛋白(MYO)、肌酸激酶同工酶(CK-MB)、血浆氨基末端脑钠肽前体(NT-proBNP)的水平与感染性休克患者预后的关系。结果:乳酸清除率>10%患者病死率显著低于乳酸清除率≤10%的患者(P<0.01);存活组乳酸清除率及各项心肌损伤标志物水平显著低于病死组(P<0.01);感染性休克患者血清心肌损伤标志物cTnT、MYO、CK-MB的水平和乳酸清除率在患者预后病死风险单独判断中的价值均具有统计学意义(P<0.01);患者的血清心肌损伤标志物联合预测患者预后的ROC曲线下面积为0.761(P<0.01);6h乳酸清除率联合心肌损伤标志物ROC曲线下面积和95%CI值明显高于单用乳酸清除率和单用心肌损伤标志物(P<0.01)。结论:乳酸清除率联合cTnT、MYO、CK-MB、NT-proBNP等心肌标志物对感染性休克预后判断具有重要作用,且评估效果显著高于各指标独立使用。

       

      Abstract: Objective:To explore the value of lactate clearance rate combined with myocardial necrosis markers levels in predicting the prognosis of patients with septic shock.Methods:One hundred and fifty-eight patients with septic shock were selected,and the curative effects in 126 cases achieved the desired goal by 6 h recovery treatment.The lactate clearance rate and myocardial necrosis markers(including cTnT,MYO,CK-MB and NT-proBNP) levels of the patients were detected at admission and after 6 h and 24 h of treatment,the relationships between the lactate clearance rate and myocardial necrosis markers levels,and prognosis of patients with septic shock were analyzed.Results:The mortality in high lactate clearance group(lactate clearance rate>10%) was significantly lower than that in low lactate clearance group(lactate clearance rate ≤ 10%)(P<0.05).The lactate clearance rate and myocardial necrosis markers levels in the survival group were obviously lower than those in death group(P<0.01).The difference of the value between the combination of lactate clearance rate and levels of cTnT,MYO and CK-MB and single application in judging the prognosis of patients was statistically significant(P<0.05).The area under ROC curve of the combined detecting of myocardial necrosis markers in predicting prognosis was 0.761(P<0.01).The area under ROC curve and 95% CI value of the 6 h lactate clearance rate combined with myocardial necrosis markers were apparently higher than those of the single use of lactate clearance rate or myocardial necrosis markers(P<0.01).Conclusions:The lactate clearance rate combined with myocardial necrosis markers has important value in predicting the prognosis of the patients with septic shock,the evaluation effect of which is significantly higher than that of the single use.

       

    /

    返回文章
    返回