早期乳酸清除率对重症感染患者预后评估的影响

Effects of early lactate clearance rate on prognosis evaluation of patients with severe infections

目的:观察早期乳酸清除率(LCR)对重症感染患者预后影响。方法:选取158例重症感染患者的资料,根据转归将患者分为死亡组(127例)和生存组(31例)。同时依据LCR 10%标准,将158例患者又分为低LCR组(72例)和高LCR组(86例)。分别比较各组患者的APACHEⅡ评分、治疗6 h后乳酸水平和清除率情况。结果:死亡组患者的治疗6 h乳酸浓度、APACHEⅡ评分较生存组高,低LCR组和高LCR组患者均低于生存组(P<0.05);低LCR组患者的6 h乳酸浓度、死亡率、APACHEⅡ评分均高于高LCR组(P<0.05);LCR≥10%且<30%的患者和≥30%患者的休克率(21.62%、18.37%)、死亡率(16.22%、8.16%)均较清除率<5%、5%~10%患者的休克率(46.43%、38.64%)、死亡率(32.14%、27.27%)低(P<0.05)。结论:早期清除感染危重症患者血乳酸水平对其预后病情改善具有促进作用。

Objective： To evaluate effects of early lactate clearance rate（ LCR） on prognosis of patients with severe infections.Methods： The data of 158 patients with severe infections were selected. These patients were divided into death group（ n = 127） and survival group（ n = 31） according to their prognosis. At the same time,according to LCR 10% standard,these patients were also divided into low LCR group（ n = 72） and high LCR group（ n = 86）. The APACHE score,the lactic acid level 6h after the treatment and the LCR among each group were compared. Results： The lactic acid level 6h after the treatment and the APACHE score of death group were higher than those of survival group,and those of low LCR group and high LCR group were lower than those of survival group（ P〈0.05）. The lactic acid level 6h after the treatment,mortality rate,and the APACHE score of low LCR group were higher than those of high LCR group（ P〈0.05）. The shock rate（ 21.62%,18.37%） and shock rate（ 16.22%,8.16%） of the patients with LCR≥10%or LCR30% were lower than those of the patients with LCR5% or LCT = 5 ~ 10%（ 46.43%,38.64%; 32.14%,27.27%）（ P〈0.05）. Conclusions： Early clearance of blood lactic acid in the patients with severe infections has a promotion effect on the prognosis.