乳酸清除率对严重脓毒症患者预后评估的价值

Prognostic evaluation value of lactate clearance rates in patients with severe sepsis

目的探讨6 h乳酸清除率对严重脓毒症患者预后评估的临床价值。方法对38例入住重症医学科的严重脓毒症患者进行急性生理学及慢性健康状况评分(APACHEⅡ评分),测定入住时及入住6 h后的血乳酸浓度,并计算乳酸清除率。将6 h乳酸清除率>10%的患者分为A组,<10%为B组。比较2组患者的APACHEⅡ评分及其死亡率,并将死亡组及存活组患者的APACHEⅡ评分及6 h乳酸清除率进行对比。结果 B组患者的APACHEⅡ评分及死亡率均显著高于A组患者,存活组的6 h乳酸清除率水平明显高于死亡组。结论 6 h乳酸清除率对严重脓毒症患者预后评估具有实际临床价值。

Objective To investigate the prognostic evaluation value of six hours lactate clearance in patients with severe sepsis.Methods Thirty- eight patients with severe sepsis were evaluated with acute physiology and chronic health evaluation（ APACHEⅡscore）before treatment. The arterial blood lactates were determined when patients hospitalized,and the lactate clearance rates after 6 hours of treatment. The patients divided into two groups. The six hours lactate clearance 10% were classified as Group A,and the six hours lactate clearance 〉10% were classified as Group B. Two groups were compared the APACHEⅡ score and mortality rate. Then compared the APACHEⅡ score and six hours lactate clearance between the death group and Survival group. Results The APACHEⅡ score and mortality rate of group B were more higher than group A. And the six hours lactate clearance in survival group was higher than death group.Conclusion 6 hours lactate clearance rate has practical clinical value for prognostic evaluation of patients with severe sepsis.