血乳酸水平与APACHEⅡ评分对感染性休克患者预后的评估价值

Value of blood lactic acid level and APACHEⅡ score in prognostic evaluation of septic shock

目的:探讨血乳酸水平与急性生理学及慢性健康状况评分系统(APACHEⅡ)评分对感染性休克患者预后的评估价值。方法:抽取2016年2月至2018年12月山西省肿瘤医院收治的感染性休克患者67例,其中最终预后生存者43例,死亡者24例。记录患者入院24 h内检测的血乳酸水平和APACHEⅡ评分,采用Pearson分析其与预后的相关性。结果:感染性休克生存者血乳酸水平为(7.56±4.67)nmol/L,APACHEⅡ评分为(28.75±12.25)分,低于死亡者(t=3.598、6.027,P<0.05);血乳酸水平与APACHEⅡ评分呈正相关(r=0.881,P<0.05);血乳酸、APACHEⅡ评分及二者联合预测患者预后的敏感度为0.542、0.750、0.750,特异度为0.886、0.932、0.955。结论:血乳酸、APACHEⅡ评分越高预示死亡风险越高,血乳酸水平联合APACHEⅡ评分可评估感染性休克患者的预后。

Objective To investigate the value of blood lactic acid level and acute physiology and chronic health evaluation scoring system(APACHEⅡ)score in prognostic evaluation of septic shock.Methods Sixty-seven patients with septic shock who were admitted to Shanxi Provincial Cancer Hospital from February 2016 to December 2018 were selected.Among them,43 patients had final prognosis and 24 died.The blood lactate levels and APACHEⅡ scores were recorded within 24 hours after admission,and their correlation with prognosis was analyzed by Pearson.Results the blood lactate level in septic shock survivors were(7.56±4.67)nmol/L,and the APACHEⅡ scores were(28.75±12.25)points,which were lower than those in deaths(t=3.598,6.027,P<0.05);there was a significant association between the blood lactic acid level and APACHEⅡ score(r=0.881,P<0.05).The sensitivity of blood lactic acid level,APACHEⅡ score and blood lactic acid level combined with APACHEⅡ score were 0.542,0.750,0.750 on estimating the prognosis of septic shock.,while the specificity were 0.886,0.932,0.955.Conclusions Higher blood lactic acid and APACHEⅡ scores indicate a higher risk of death.Blood lactic acid levels combined with APACHEⅡ scores can estimate the prognosis of patients with septic shock.