早期乳酸清除率评估严重脓毒症预后的临床价值

Clinical analysis of early lactate clearance in the prognosis of patients with severe sepsis.

目的探讨早期乳酸清除率对评估严重脓毒症患者预后的价值。方法收集海南省人民医院重症医学科2011年1月至2012年1月64例严重脓毒症患者,记录确诊后初始动脉血乳酸、6h乳酸清除率、24h内APACHEⅡ评分及患者的转归。分别按临床转归将患者分为存活组和死亡组,以血乳酸清除率10%为界分为高乳酸清除率组和低乳酸清除率组,比较其差异性。结果各组间年龄、性别构成、初始动脉血乳酸差异无统计学意义(P>0.05)。存活组6h乳酸清除率明显高于死亡组,高乳酸清除率组病死率明显低于低乳酸清除率组,差异均有统计学意义(P<0.05)。结论早期乳酸清除率对严重脓毒症预后评估具有一定价值。

Objective To evaluate the value of early lactate clearance in the prognosis of severe sepsis. Methods The clinical data of 64 patients with severe sepsis admitted from January 2011 and January 2012 in the People’s Hospital of Hainan Province was analyzed. The baseline lactate, 6-hour lactate clearance, APACHEⅡ score in 24 hours and the prognosis were recorded. The patients were divided into the survival group and the non-survival group according to the clinical outcome, and were divided into the low lactate clearance group and the high lactate clearance group according to the clearance rate of 10% as the boundary. Statistical analysis was performed. Results There were no statistically significant difference between the groups in age, sex, and the baseline of lactate （P〉0.05）. The 6-hour lactate clearance in the survival group was significantly higher than that in the non-survival group. The mortality rate in the high lactate clearance group was significantly lower than that in the low lactate group （P〈0.05）. Conclusion Early lactate clearance is valuable to the evaluation of the prognosis of patients with severe sepsis.