乳酸清除率对休克病人预后的预测意义

The Significance of Lactate Clearance Rate on the Prognosis Prediction of Shock Patient Mortality

目的：探讨乳酸清除率对休克病人预后的预测意义。方法：回顾性分析我院2012年3月。2014年5月收治的59例感染性休克（SS）病人，根据28d的转归分为死亡组（39例）和生存组（20例），比较2组患者72小时内血乳酸水平变化，分析乳酸清除率与APACHEII评分以及病人死亡率的关系。结果：死亡组患者入院时、入院6、12、24、72小时的乳酸浓度明显高于存活组（t=2．801、4．975、8．685、11．041、11．037，P=0．000〈0．05），生存组入院6小时后乳酸水平呈下降趋势，而死亡组呈波动上升趋势；入院后6、12、24小时的乳酸清除率显著低于存活组（t=8．596、6．964、15．194，P=0．000〈0．05）；并且以12小时乳酸清除率为观察点，发现随着乳酸清除率的升高，病人死亡率明显降低（P〈0．05）。6小时乳酸清除率超过20％的SS患者的死亡率明显低于〈20％的患者（P〈0．05）。结论t早期乳酸清除率有利于评估SS病人的预后转归，乳酸清除率越低，预后越差，死亡率越高。

Objective： To study the significance d lactate clearance rate on the prediction of shock patient mortality. Methods： 59 cases of septic shock （SS） patients in our hospital from 2012 March to 2014 May were retrospectively analyzed, According to the outcome of 28d is divided into the death group （39 cases） and the survival group （20 cases）, the changes of blood lactic acid level with 72h in the two groups patients were compared, the re]atiouship between the lactic acid clearance rate and APACHE II score, the mortality of the pa- tients were analyzed. Results： The levels of lactic acid in the death group at the time of admission, after 6, 12, 24, 72h was significantly higher than that in the survival group （ t = 2.801,4.975,8. 685,11.041,11： 037, P = 0. 000 〈 0.05 ）, Survival group 6 h after admission lactic acid level was on the decline, and death group showed a trend of fluctuations rise; Admission 6h, 12h, 24h, lactic acid clearance rate of patients was significantly lower than the survival group （t = 8. 596,6. 964,15. 194, P = 0.000 〈 0.05 ） ; And with 12h lactate clear- ance rate for observation, found that as the increase of lactate clearance rate, mortality decreased significantly （ P 〈0.05 ）. the mortality in the 6h lactate clearance rate of more than 20% patients was significantly lower than that of 〈 20% patients （ P 〈 0.05 ）. Conclusion： Early lactate clearance rate is conducive to the evaluation of prognosis in patients with SS, the clearance rate is low, the mortality is high.