不同致病原因重症患者血乳酸状况及其对预后的影响

Lactate levels induced by different causes and prognostic effect for the severe patients

目的探讨重症监护病房（ICU）患者不同致病原因导致的血乳酸状况及对预后的影响。方法收集2007—05—2009—05入住我院ICU不同原因缺氧的患者315例，分为低张性缺氧组（A组）、循环性缺氧组（B组）、低张性缺氧合并循环性缺氧组（C组）、循环性缺氧合并血液性缺氧组（D组）和三种缺氧同时存在组（E组）五组。在同一治疗原则下动态监测动脉血乳酸水平，并统计患者死亡率。结果D、E两组血乳酸最高，其次是B、c两组，A组血乳酸最低；血乳酸降至正常时间A、D、E组较短，B、c较长；死亡率B、c两组较高，A、D、E组较低；不同致病原因重症患者之间血乳酸状况及预后比较差异有统计学意义。结论不同致病原因的重症患者血乳酸水平、降至正常时间及对预后的影响是不同的，正确分析血乳酸升高的原因对病情的判断有一定帮助。

Objective To study lactate levels induced by different causes and prognostic effect for the severe patients in ICU. Methods To collect 315 patients with hypoxia of different causes in our ICU from May 2007 to May 2009. All the patients were divided into five groups ： hypotonic hypoxia group （group A ）, periodic hypoxia group （group B）, hypotonic and periodic hypoxia group （group C ）, periodic and hemie hypoxia group （ group D）, and hypotonie, periodic and bernie hypoxia group （ group E ）. To dynamically monitor arterial lactate levels with the same therapeutic principle and calculate the mortality rates. Results The lactate levels were the highest in group D and E, the next was group B, C and A in order. The lactate returned to normal level with shorter time in group A, D and E, it was opposite in group B and C. The mortality rates of group B and C were higher, it was lower in group A, D and E. Conclusion They are different including lactate levels with different causes, the time that lactate returns to normal level, prognostic effect of the severe patients. Correct analysis of the reasons of high lactate level is helpful for the judgment of patient＇s condition.