产科危重病患者动脉血乳酸水平与改良APACHE Ⅱ评分的相关性

Study on the Correlation between Arterial Blood Lactate Levels and Improved APACHE Ⅱ Scores in Critically Ill Obstetric Patients

目的 控讨产科危重病患者动脉血乳酸水平与改良APACHE Ⅱ评分的相关性。方法 选择昆明市妇幼保健院专科ICU病房从2016年12月至2018年12月期间的转入的142 例危重产科患者作为研究对象,对其入室24 h内进行改良APACHE Ⅱ评分,并利用血气分析仪监测患者转入及转出时动脉血乳酸水平;比较存活与死亡患者改良APACHE Ⅱ评分与动脉血乳酸水平的关系,评估动脉血乳酸水平与改良APACHE II评分的相关性。结果 改良APACHE II评分≤20分患者动脉血乳酸水平比较差异无统计学意义(P > 0.05);> 20分患者,差异有统计学意义(P < 0.05);死亡患者改良APACHE Ⅱ评分(51)分高于存活患者(16±4.32)分,动脉血乳酸水平(8.76±0.0)mmol/L高于存活患者(2.82±1.36)mmol/L(出室时),差异有统计学意义(P < 0.05);动脉血乳酸水平与改良APACHE II评分呈显著正相关(r = 0.641,P < 0.05)。结论 随着改良APACHE II评分的增加,动脉血乳酸水平增加,两者呈正相关,动脉血乳酸水平与改良APACHE Ⅱ评分是反映产科危重病患者病情严重程度和预测患者转归的良好指标。

Objective To study the correlation between arterial blood lactate levels and modified APACHE II scores in critically ill obstetric patients. Methods 142 critical obstetric patients transferred from ICU ward of Kunming Maternal and Child Health Hospital from December 2016 to December 2018 were selected as the study subjects. The modified APACHE II scores were performed within 24 hours of admission, and the arterial blood lactate levels were monitored by blood gas analyzer. The relationship between the improved APACHE II scores and the arterial blood lactate levels was compared between survival and death patients, and the arterial blood lactate levels were evaluated. Results There were no significant differences when improved APACHE II scores were below 20(P > 0.05), and there were significant differences when improved APACHE II scores were above 20(P < 0.05). Patients who died had higher improved APACHE II scores (51) than the survivors (16±4.32) and arterial blood lactate level (8.76±0.0mmol/L) was higher than the survivors (2.82 ±1.36) mmol/L( when they left the room),which had significant difference (P < 0.05). The levels of lactic acid in arterial blood were positively correlated with the improved APACHE II scores (r = 0.641, P < 0.05). Conclusion With the increase of modified APACHE II scores, the levels of lactic acid in arterial blood increased, which was positively correlated. The levels of lactic acid in arterial blood and modified APACHE II scores were good indicators reflecting the severity of critical obstetric illness and predicting the prognosis of patients.