张亮. 早期乳酸清除率对严重脓毒症和脓毒性休克预后的影响[J]. 蚌埠医学院学报, 2016, 41(4): 499-501. DOI: 10.13898/j.cnki.issn.1000-2200.2016.04.024
    引用本文: 张亮. 早期乳酸清除率对严重脓毒症和脓毒性休克预后的影响[J]. 蚌埠医学院学报, 2016, 41(4): 499-501. DOI: 10.13898/j.cnki.issn.1000-2200.2016.04.024
    ZHANG Liang. The relationship between the early lactate clearance rate and the prognosis of patients with severe sepsis and septic shock[J]. Journal of Bengbu Medical College, 2016, 41(4): 499-501. DOI: 10.13898/j.cnki.issn.1000-2200.2016.04.024
    Citation: ZHANG Liang. The relationship between the early lactate clearance rate and the prognosis of patients with severe sepsis and septic shock[J]. Journal of Bengbu Medical College, 2016, 41(4): 499-501. DOI: 10.13898/j.cnki.issn.1000-2200.2016.04.024

    早期乳酸清除率对严重脓毒症和脓毒性休克预后的影响

    The relationship between the early lactate clearance rate and the prognosis of patients with severe sepsis and septic shock

    • 摘要: 目的:探讨早期乳酸清除率对严重脓毒症及脓毒性休克预后的影响。方法:收集112例严重脓毒症及脓毒性休克病例,监测其入院时及入院6 h的乳酸水平,计算乳酸清除率。将患者分为高乳酸清除率(乳酸清除率>10%)组和低乳酸清除率(乳酸清除率 ≤ 10%)组,比较2组病死率、初始乳酸水平和APACHE Ⅱ评分。随访30 d,根据患者生存情况将患者分为存活组和死亡组,比较2组动脉血乳酸水平、早期乳酸清除率及APACHE Ⅱ评分。结果:高乳酸清除率组和低乳酸清除率组初始乳酸水平差异有统计学意义(P<0.01)。高乳酸清除率组病死率和APACHE Ⅱ评分均明显低于低乳酸清除率组(P<0.01),随访30 d后,病死45例,存活67例,存活组APACHE Ⅱ评分明显低于病死组(P<0.01)。存活组早期乳酸清除率明显高于病死组(P<0.01)。结论:早期乳酸清除率可以作为判断严重脓毒症及脓毒性休克患者预后的一个重要指标。

       

      Abstract: Objective: To discuss the effects of early lactate clearance rate on the prognosis of patients with severe sepsis and septic shock. Methods: The lactic acid levels in 112 patients with severe sepsis and septic shock were measured at admission and at 6 hours of admission, and the lactate clearance rates of all cases were calculated. All patients were divided into the high lactate clearance rate group(the lactate clearance rate more than 10%) and low lactate clearance rate group(the lactate clearance rate less than 10%). The mortality, initial level of lactic acid and APACHE Ⅱ score between two groups were compared. All patients were followed up for 30 days, and divided into the survival group and death group according to their survival. The arterial blood lactate level, early lactate clearance rate and APACHE Ⅱ score between two groups were compared. Results: The difference of the initial level of lactic acid between the high lactate clearance rate group and low lactate clearance rate group was statistically significant(P<0.01). The mortality and APACHE Ⅱ score in high lactate clearance rate group were significantly lower than those in low lactate clearance rate group(P<0.01). Fifty-five cases died and 67 cases survived after 30 days of following up. The APACHE Ⅱ score in survival group was significantly lower than that in mortality group(P<0.01). The lactate clearance rate in survival group in the early period was significantly higher than that in mortality group(P<0.01). Conclusions: The early lactate clearance rate is an important index and more reliability in judging the prognosis of patients with severe sepsis and septic shock.

       

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