感染性休克患儿血乳酸水平的变化及临床意义

Clinical significance of the changes of blood lactic acid in children with septic shock

目的探讨感染性休克患儿血乳酸水平的变化及其临床意义。方法检测100例感染性休克患者(代偿组88例,失代偿组12例)0h(以诊断为感染性休克为研究起点)、24h动脉血乳酸水平。选择同期体检健康的小儿98例为对照组。以痊愈出院或转院或死亡为研究终点,按预后不同将患儿分为好转组与加重组,分析其血乳酸与病情严重度的关系及对预后的影响。结果①入院时代偿组、失代偿组血乳酸水平均高于对照组(t=12.21,P=0.00;t=8.76,P=0.00),其中失代偿组高于代偿组(t=6.66,P=0.00)。②血乳酸在加重组高于好转组,治疗后好转组回降,而加重组则呈不同程度上升。结论监测血乳酸水平的动态变化,有助于判断感染性休克患儿的病情危重程度及预后。

Objective To investigate the clinical significance of the changes of blood lactic acid in children with septic shock. Methods Arterial blood lactate were detected in 100 children with septic shock（compensated shock group, 88 cases;decompensated shock group, 12 cases） before treatment （0 hour, the research began with patients were diagnosed with septic shock） and 24 hours after the treatment. The controls included 98 healthy children at the same time. The research end - time points at patients＇ cure or death. According to the results of follow - up, the pa- tients were divided into improved group and worsened group. The association between lactic acid and the disease severity and its impact on prognosis were analysed. Results （DCompared with control group, blood lactate was higher in compensated shock group and decompensated shock group on admission （ t = 12.21, P = 0.00 ; t = 8.76, P = 0.00）, of which decompensated shock group was higher than compensated shock group （ t = 6.66, P = 0.00）. Blood lactate levels in worsened . group was higher than that in improved group. After treated, blood lactate in im- proved group decreased but increased in worsened group. Conclusion may be helpful for predicting the severity and prognosis in children with Monitoring dynamic changes of blood lactate septic shock.