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

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.