血乳酸/肌酐与脓毒症休克患者近期预后的关系

Relationship Between Blood Lactate Acid/Creatinine and Short-Term Prognosis in Patients with Septic Shock

目的探析血乳酸(Lac)/肌酐(Scr)与脓毒症休克患者近期预后的关系。方法前瞻性选取新乡市第一人民医院2022年1月至2023年3月收治的140例脓毒症休克患者为研究对象,于入院时详细记录患者一般资料,并进行实验室检查,检测血Lac、Scr,计算二者比值。依据28 d生存情况将患者分为病死组与存活组,比较两组一般资料及实验室检查资料,采用点二列相关性分析Lac/Scr与脓毒症休克患者近期预后的关系,并绘制受试者工作特征(ROC)曲线,分析Lac/Scr对脓毒症休克患者短期病死的预测价值。结果140例脓毒症休克患者中3例患者家属放弃治疗,最终纳入137例脓毒症休克患者,共有31例患者28 d内病死,占比22.63%。病死组年龄、急性生理与慢性健康(APACHEⅡ)评分、Lac、Lac/Scr均高于存活组(P<0.05)。病死组氧合指数低于存活组(P<0.05)。点二列相关性分析显示,Lac、Lac/Scr与脓毒症休克患者近期预后病死呈正相关(r>0,P<0.05)。ROC曲线显示Lac、Lac/Scr预测脓毒症休克患者短期病死的曲线下面积(AUC)>0.7,且Lac/Scr的AUC值更高。结论血Lac/Scr可影响脓毒症休克患者近期预后,Lac/Scr水平越高患者短期内病死风险越大,且血Lac/Scr可作为预测脓毒症休克患者近期预后的敏感指标。

Objective To explore the relationship between blood lactate acid(Lac)/serum creatinine(Scr)and short-term prognosis in patients with septic shock.Methods A prospective study was conducted on 140 patients with septic shock admitted to the Xinxiang First People’s Hospital from January 2022 to March 2023.General information of the patients was recorded in detail at admission,and laboratory examinations were conducted to detect blood Lac and Scr,and the ratio between the two was calculated.Patients were divided into a mortality group and a survival group based on their 28 days survival status.General and laboratory examination data were compared between the two groups.The relationship between Lac/Scr and short-term prognosis of septic shock patients was analyzed using point two column correlation analysis,and the receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of Lac/Scr for short-term mortality in septic shock patients.Results Among the 140 patients with septic shock,3 of their families abandoned treatment,and 137 patients with septic shock were ultimately included.A total of 31 patients died within 28 days,accounting for 22.63%.The age,acute physiology and chronic health(APACHE II)score,Lac,Lac/Scr of the mortality group were higher than those of the survival group(P<0.05).The oxygenation index of the mortality group was lower than that of the survival group(P<0.05).Point two column correlation analysis showed that Lac,Lac/Scr were positively correlated with short-term prognosis and mortality in patients with septic shock(r>1,P<0.05).The receiver operating characteristic curve showed that the area under the curve(AUC)of Lac and Lac/Scr for predicting short-term mortality in septic shock patients was>0.7,and the AUC value of Lac/Scr was higher.Conclusion Blood Lac/Scr can affect the short-term prognosis of patients with septic shock.The higher the Lac/Scr level,the greater the risk of short-term mortality in patients.Blood Lac/Scr can be a sensitive indicator for predicting the short-term prognosis of patients with septic shock.