血乳酸和APACHEⅡ评分对ICU危重病患者预后的评估价值

The evaluating effect of blood lactate and APACHE Ⅱ score on prognosis of critical patients in ICU

目的研究危重患者血乳酸水平和慢性健康状况评分(APACHEⅡ评分)对危重患者预后的评估作用。方法对入住重症医学科106例危重患者在入院0.5 h、12 h、48 h后分别进行血乳酸水平的测定,进行血乳酸水平与APACHEⅡ评分的相关性分析。结果危重病患者的死亡危险性与血乳酸浓度有着高度相关性。乳酸高度升高组患者病死率显著高于正常组(P<0.05);病死组患者血乳酸浓度显著高于存活组(P<0.05);随着血乳酸浓度增高,病死率从11.11%增加至45.95%(P<0.05),而死亡组患者的血乳酸浓度、APACHEⅡ评分分值较存活组明显增高,差异有统计学意义(P<0.05)。APACHEⅡ评分与血乳酸浓度呈正相关(r=0.714,P<0.001)。结论血乳酸水平与APACHEⅡ评分呈正相关,血乳酸水平可作为判断危重病预后的参考指标。

Objective To search the evaluating effect of blood lactate and APACHE II score on prognosis of critical patients. Method The blood lactate levels of 106 patients were examined in 30rain, 12 hours, 48 hours when they were ad-mitted in intensive care unit （ICU）, the correlation between blood lactate levels and APACHE 11 score was analysed. Result The death-rate in critically ill group who had higher blood lactate was significantly higher than that in normal group （P 〈 0.05）, increases with the concentration of blood lactate, morality increased from 11.11% to 45.95 % （ P 〈 0.05）, the risk of death and concentration of blood lactate were highly correlated in critically ill patients. The concentration of blood lactate was positive correlation with APACHE II score（r = 0.714, P 〈 0.001 ）. Conclusions The concentration of blood lactate is valuable of predicting prognosis of critical patients, and which was positive correlation with APACHE II score.