感染性休克患者血乳酸测定的临床意义

Clinical significance of determination of blood lactate of patients with septic shock

目的:探讨血乳酸水平与感染性休克患者预后的关系。方法:58例感染性休克患者分为存活组和死亡组,动态监测血乳酸值及进行APACHEⅡ评分,比较上述指标的差异性。结果:①对照组、感染性休克患者存活组、死亡组治疗前动脉血乳酸水平分别为(0.63±0.33)mmol/L,(2.88±0.35)mmol/L,(7.54±0.66)mmol/L,感染性休克患者存活组血乳酸水平较对照组明显增高(P<0.05);死亡组血乳酸水平较存活组明显升高(P<0.05)。②感染性休克患者存活组血乳酸在48 h内达到正常,而死亡组患者的血乳酸明显高于存活组(P<0.05),随着血乳酸浓度的下降感染性休克患者的严重程度降低,生存率显著提高。③死亡组患者APACHEⅡ评分分值明显高于存活组(P<0.05),APACHEⅡ评分与血乳酸浓度显著正相关(r=0.674)。结论:血乳酸测定对于判断感染性休克患者病情预后具有重要价值。

Objective： To study the relationship between the blood lactic acidosis and prognosis of patients with septic shock. Methods： 58 cases of septic shock patients were divided into survival group and death group.Blood lactate levels and APACHE Ⅱ score were detected dynamically.All the difference were analyzed. Results： ①Before treatment,the lactic levels were（0.63±0.33） mmol/L in normal group,（2.88±0.35） mmol/L in survival group,and（7.54±0.66） mmol/L in death group respectively（P0.05）.②The patient＇s blood lactic acid of survival gruoup becomed to normal in 48 h,the patient＇s blood lactic acid of died group was significantly higher than the survival group during a period of longer time（P 0.05）.With the decline of the blood lactic acid density,the septic shock patients turned better,and the survival rate was significantly increased.③The APACHEⅡ score in death group was higher than that in survival group（P0.05）,The APACHEⅡ score was positive correlated with blood lactic acid level（r=0.674）. Conclusion： Blood lactic acid has an important value for the prognosis of the judgment in septic shock patients.