血乳酸、胆碱酯酶、APACHEⅡ评分对老年重症肺炎患者预后的评估价值

Evaluation value of blood lactate,cholinesterase and APACHEⅡscore on the prognosis of elderly patients with severe pneumonia

目的探讨血乳酸、胆碱酯酶、急性生理学及慢性健康状况评分系统Ⅱ(APACHEⅡ)评分对老年重症肺炎患者预后的评估价值。方法选取2019年1月至2020年12月我院收治的96例老年重症肺炎患者为研究对象,以入院后14 d是否存活将其分为存活组(52例)和死亡组(44例)。收集两组的血乳酸、胆碱酯酶检测数据,计算24 h血乳酸清除率,记录APACHEⅡ评分。分析APACHEⅡ评分与24 h血乳酸清除率、入院72 h胆碱酯酶的相关性。结果入院时,两组的血乳酸水平比较,差异无统计学意义(P>0.05);入院7 d,死亡组的血乳酸水平高于存活组,差异具有统计学意义(P<0.05)。入院时,两组的胆碱酯酶水平比较,差异无统计学意义(P>0.05);入院72 h,死亡组的胆碱酯酶水平低于存活组,差异具有统计学意义(P<0.05)。存活组的24 h血乳酸清除率高于死亡组,差异具有统计学意义(P<0.05)。入院时,两组的APACHEⅡ评分比较,差异无统计学意义(P>0.05);入院24、48 h,死亡组的APACHEⅡ评分高于存活组,差异具有统计学意义(P<0.05)。Speraman相关性分析结果显示,APACHEⅡ评分与24 h血乳酸清除率、入院72 h胆碱酯酶呈负相关(P<0.001)。结论血乳酸、胆碱酯酶、APACHEⅡ评分可作为判断老年重症肺炎患者预后的重要指标。

Objective To explore the evaluation value of blood lactate,cholinesterase and Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score on the prognosis of elderly patients with severe pneumonia.Methods A total of 96 elderly patients with severe pneumonia admitted in our hospital from January 2019 to December 2020 were selected as the research objects.The patients were divided into survival group(52 cases)and death group(44 cases)based on whether survived 14 d after admission.The blood lactate and cholinesterase test datas of the two groups were collected,the 24 h blood lactate clearance rate was calculated,and the APACHEⅡscore was recorded.The correlation between APACHEⅡscore and 24 h blood lactate clearance rate and 72 h cholinesterase were analyzed.Results At admission,there was no significant difference in blood lactate level between the two groups(P>0.05);at 7 d after admission,the blood lactate level in the death group was higher than that in the survival group,and the difference was statistically significant(P<0.05).At admission,there was no significant difference in cholinesterase level between the two groups(P>0.05);at 72 h after admission,the cholinesterase level in the death group was lower than that in the survival group,and the difference was statistically significant(P<0.05).The 24 h blood lactate clearance rate of the survival group was higher than that of the death group,and the difference was statistically significant(P<0.05).At admission,there was no significant difference in APACHEⅡscore between the two groups(P>0.05);at 24,48 h after admission,the APACHEⅡscore of the death group was higher than that of the survival group,and the difference was statistically significant(P<0.05).Speraman correlation analysis results showed that APACHEⅡscore was negatively correlated with 24 h blood lactate clearance rate and 72 h cholinesterase(P<0.001).Conclusion Blood lactate,cholinesterase and APACHEⅡscore can be used as important indexes to judge the prognosis of elderly patients with severe pneumonia.