重症监护病房病人血乳酸水平与疾病转归关联分析

THE CLINICAL ANALYSIS OF PLASMA LACTIC ACID LEVELS IN THE ICU PATIENTS

目的检测重症监护病房（ICU）病人血乳酸（LAC）水平，探讨其诊断价值。方法采用干化学法测定ICU患者LAC的浓度，结合病案室资料，分析2550例ICU病人血乳酸浓度与疾病预后的关系。结果将2550例ICU病人分成两组，分别是死亡组和存活组。死亡组LAC阳性率为90．9％，明显高于存活组LAC阳性率34．8％（p〈0．01）。ICU病人中脑梗死、脑出血的患者和慢支、肺感染患者乳酸阳性率最高，达74．9％～76．6％；随着LAC水平的逐渐升高（从〈2．4mmol／L到〉10mmol／L），ICU病人的预后渐差，死亡率亦有逐渐升高趋势（从21．1％到96．6％）。结论血乳酸可作为ICU病人病情监测和判断预后的指标。

Objective To investigate the diagnosis value of plasma laetic（LAC） level in the Intensive Care Unit （ICU） patients. Method Detecting LAC by the method of chemical dipstick combined with the clinical data of the patients, we analyzed the relationship between the prognosis in the ICU patients and the level of LAC. Result 2 550 ICU patients were divided into deaths group and survival group. The rate of LAC positive in the deaths group is 90. 9%, which obviously higher than the survival group＇ s positive rate of LAC （34h8%）, （p 〈0. 01 ）. Especially in the patients suffering from cerebral infarction, cerebral hemorrhage, chronic bronchitis and pulmonary infection, the LAC positive rate could come up to 74. 9% - 76. 6%. The prognosis of the patients corresponded to the level of the LAC. The mortality could be higher in the patients with a high level of LAC. Conclusion As the prognosis of the ICU patients was related to the LAC level, detecting the LAC could be an effective means to monitor the state of illness.