血乳酸、白蛋白水平对脓毒症伴急性呼吸窘迫综合征患者生存状况的影响

Influence of Blood Lactic Acid and Albumin Levels on the Survival Status of Patients with Sepsis and Acute Respiratory Distress Syndrome

目的探讨血乳酸、白蛋白(ALB)水平对脓毒症伴急性呼吸窘迫综合征患者生存状况的影响。方法选取2020年1月至2022年6月我院收治的98例脓毒症伴急性呼吸窘迫综合征患者,根据其入院28d内生存状况分为死亡组(49例)和存活组(49例)。统计比较两组患者的基线资料、入院时白细胞计数(WBC)、血乳酸及ALB水平,经COX生存回归分析血乳酸、ALB水平对脓毒症伴急性呼吸窘迫综合征患者生存状况的影响。结果死亡组血乳酸水平高于存活组,ALB水平低于存活组(P<0.05);两组的年龄、性别、体重指数、长期吸烟史、侵入性置管、WBC比较无统计学差异(P>0.05);经COX生存回归分析显示,血乳酸高表达为脓毒症伴急性呼吸窘迫综合征患者生存状况的危险因子(HR>1,P<0.05),而ALB高表达为其保护因子(HR<1,P<0.05)。结论脓毒症伴急性呼吸窘迫综合征患者生存状况与其血乳酸、ALB水平关系密切,血乳酸高表达、ALB低表达会增加其死亡风险,临床需采取针对性干预措施,以减少其死亡的发生。

Objective To explore the influence of blood lactic acid and albumin(ALB)levels on the survival status of patients with sepsis and acute respiratory distress syndrome.Methods 98 patients with sepsis and acute respiratory distress syndrome admitted to our hospital from January 2020 to June 2022 were selected and divided into death group(49 cases)and survival group(49 cases)according to the survival status within 28 days after admission.The baseline data,white blood cell count(WBC),blood lactic acid and ALB levels at admission were counted and compared between the two groups.The influence of blood lactic acid and ALB levels on survival status of patients with sepsis and acute respiratory distress syndrome was analyzed by COX survival regression.Results The blood lactic acid level of the death group was higher than that of the survival group,and the ALB level was lower than that of the survival group(P<0.05).No statistical difference was found in the age,gender,body mass index,long-term smoking history,invasive catheterization and WBC between the two groups(P>0.05).COX survival regression analysis showed that high expression of blood lactate was risk factor for survival in patients with sepsis and acute respiratory distress syndrome(HR>1,P<0.05)and the high expression of ALB is the protective factor(HR<1,P<0.05).Conclusions The survival status of patients with sepsis and acute respiratory distress syndrome is closely related to the blood lactate and ALB levels,high expression of blood lactate and low expression of ALB will increase the death risk,and targeted intervention measures need to be taken in clinical practice to reduce the death.