血乳酸水平对大面积特重烧伤早期急性肾损伤加重的预测价值

The predictive value of blood lactate level on the aggravation of acute renal injury in the early stage of extensive severe burn

目的:探讨血乳酸水平对大面积特重烧伤早期急性肾损伤加重的预测价值。方法:回顾性分析2016年5月—2018年6月收治的40例大面积特重烧伤合并早期急性肾损伤(AKI)患者的资料,按是否出现AKI加重将其分为未加重组(17例)及加重组(23例)。分析两组入院时血小板计数、血红蛋白及白细胞计数等指标水平,比较两组血滤器使用时间、尿量明显增加时间以及1个月患者死亡情况;分析两组烧伤后住院时及72 h时血肌酐、血乳酸水平。结果:入院时,未加重组的首日尿量明显高于加重组(P<0.05),两组白细胞计数、血红蛋白、血小板计数比较,差异无统计学意义(P>0.05);两组血滤机使用时间及尿量明显增加时间比较,差异无统计学意义(P>0.05);未加重组30 d内死亡率明显低于加重组(P<0.05)。入院时,未加重组的血乳酸水平明显低于加重组(P<0.05),两组血肌酐水平比较,差异无统计学意义(P>0.05);入院72 h时,未加重组血肌酐水平明显低于加重组,但两组血乳酸水平比较,差异无统计学意义(P>0.05)。结论:早期血乳酸水平可有效预测大面积特重烧伤患者急性肾损伤加重。

Objective:To explore the predictive value of blood lactate level on the aggravation of acute renal injury in the early stage of severe burn.Methods:The data of 40 patients with large area severe burn and early acute kidney injury(AKI)treated in hospital from May 2016 to June 2018 were analyzed retrospectively.According to whether AKI worsened,they were divided into two groups:non recombined(n=17)and recombined(n=23).The levels of platelet,hemoglobin and plasma white protein were collected at admission.The recovery time of peripheral temperature and the time of significant increase of urine volume were compared between the two groups.The level of serum creatinine and lactate were collected immediately after burn and 72 hours after burn.Results:At the time of admission,the urine volume of the first day without recombination was significantly higher than that of the first day without recombination(P<0.05),and there was no significant difference between the two groups in the white blood cell count level,hemoglobin level and platelet count level(P>0.05),there was no significant difference between the two groups in the time of temperature recovery and urine volume increase(P>0.05),the mortality rate within 30 days without recombination was significantly lower than that of the first day without recombination(P<0.05).At the time of admission,the blood lactate level without recombination was significantly lower than that without recombination(P<0.05),and there was no significant difference between the two groups(P>0.05),at 72 hours after admission,the blood creatinine level without recombination was significantly lower than that without recombination,but there was no significant difference between the two groups(P>0.05).Conclusion:Early blood lactate level can effectively predict the aggravation of acute renal injury in patients with extensive severe burn.