Objective:To explore the easily applicable indicators of practical value to evaluate the prognosis of acute respiratory distress syndrome（ARDS）.Methods:Blood and biochemical tests and bloodgas analyses were performe...Objective:To explore the easily applicable indicators of practical value to evaluate the prognosis of acute respiratory distress syndrome（ARDS）.Methods:Blood and biochemical tests and bloodgas analyses were performed upon entry into the ICUs,12 h,24 h,48 h and 72 h after that in 72 ARDS patients（who were admitted to the ICUs of our hospital from January 2000 to December 2009）.Then APACHEⅡscores were achieved by combining relevant physiological parameters and laboratory results.Results:There was a statistical difference between the death group and survival group at different time points upon entering the ICUs in terms of APACHEⅡscore, alveolar-arterial oxygen difference and arterial blood lactate clearance rate.PaO<sub>2</sub>/FiO<sub>2</sub> values were recorded to be statistically different between the death group and survival group 24 h,48 h and 72 h,respectively after entry into the ICUs.In addition,registered linear regression existed between APACHEⅡscore,alveolar-arterial oxygen difference or PaO<sub>2</sub>/FiO<sub>2</sub> value and time. APACHEⅡscore 24 h and 72 h after entering ICUs predicted mortality with an area under the ROC curve（AUC） standing respectively at 0.919 and 0.9SS.Arterial blood lactate clearance rate 12 h, 24 h,48 h and 72 h after entering ICUs predicted mortality with an area under the ROC curve （AUC） at 0.918,0.918,0.909 and 0.991,respectively.Conclusions:APACHEⅡscore applied in combination with arterial blood lactate clearance rate is of clinical significance in assessing the prognosis of ARDS patients.展开更多
Background Early evaluation of prognosis in cardiogenic shock(CS)is crucial for tailored treatment selection.Both lactate clearance and lactate levels are considered useful prognostic biomarkers in patients with CS.Ho...Background Early evaluation of prognosis in cardiogenic shock(CS)is crucial for tailored treatment selection.Both lactate clearance and lactate levels are considered useful prognostic biomarkers in patients with CS.However,there is yet no literature comparing the 6-hour lactate clearance rate(Δ6Lac)with lactate levels measured at admission(L1)and after 6 h(L2)to predict 30-day mortality in CS.Methods In this observational cohort study,95 patients with CS were treated at Department of Intensive Care Unit,Yiwu Central Hospital between January 2020 and December 2022.Of these,88 patients met the eligibility criteria.The lactate levels were measured after admission(L1)as the baseline lactate value,and were measured after 6 h(L2)following admission.The primary endpoint of the study was survival rate at 30 days.A receiver operating characteristic curve was used for data analysis.Univariate and multivariate Cox regression analyses were performed based onΔ6Lac.Kaplan–Meier(KM)survival curves were generated to compare the 30-day survival rates among L1,L2,andΔ6Lac.Results TheΔ6Lac model showed the highest area under the curve value(0.839),followed by the L2(0.805)and L1(0.668)models.TheΔ6Lac model showed a sensitivity of 84.2%and specificity of 75.4%.The L1 and L2 models had sensitivities of 57.9%each and specificities of 89.9%and 98.6%,respectively.The cut-off values forΔ6Lac,L1,and L2 were 18.2%,6.7 mmol/L,and 6.1 mmol/L,respectively.Univariate Cox regression analysis revealed a significant association betweenΔ6Lac and 30-day mortality.After adjusting for five models in multivariate Cox regression,Δ6Lac remained a significant risk factor for 30-day mortality in patients with CS.In our fifth multivariate Cox regression model,Δ6Lac remained a risk factor associated with 30-day mortality(hazard ratio[HR]=5.14,95%confidence interval[CI]:1.48 to 17.89,P=0.010)as well as L2(HR=8.42,95%CI:1.26 to 56.22,P=0.028).The KM survival curve analysis revealed that L1>6.7 mmol/L(HR=8.08,95%CI:3.23 to 20.20,P<0.001),L2>6.1 mmol/L(HR=25.97,95%CI:9.76 to 69.15,P<0.001),andΔ6Lac≤18.2%(HR=8.92,95%CI:2.95 to 26.95,P<0.001)were associated with a higher risk of 30-day mortality.ConclusionsΔ6Lac is a better predictor for 30-day mortality in CS than lactate levels at admission.It has a predictive value equivalent to that of lactate level at 6 h after admission,making it an important surrogate indicator for evaluating the suitability as well as poor prognosis after CS treatment.We found that a cut-off value of 18.2%forΔ6Lac provided the most accurate assessment of early prognosis in CS.展开更多
目的探讨静脉-动脉二氧化碳含量差/动脉-静脉氧含量差(Cv-a CO2/Ca-v O2)、乳酸清除率(LCR)与下腔静脉内径呼吸变异指数(IVCrvi)作为脓毒症休克患者早期复苏终点指标的可行性及价值。方法选取2016年6月至2018年2月该院收治的脓毒性休克...目的探讨静脉-动脉二氧化碳含量差/动脉-静脉氧含量差(Cv-a CO2/Ca-v O2)、乳酸清除率(LCR)与下腔静脉内径呼吸变异指数(IVCrvi)作为脓毒症休克患者早期复苏终点指标的可行性及价值。方法选取2016年6月至2018年2月该院收治的脓毒性休克患者60例,均进行早期液体复苏治疗,应用Cv-a CO2/Ca-v O2、LCR、IVCrvi进行评估,以尿量大于0.5 m L/(kg·h)、平均动脉压大于65 mm Hg(1 mm Hg=0.133 k Pa)为达标,根据达标情况将患者分为达标组和未达标组。结果复苏治疗后所有患者Cv-a CO2/Ca-v O2、LCR及IVCrvi等指标均得到明显改善,达标组患者指标改善情况优于未达标组,差异均有统计学意义(P<0.05)。结论脓毒症休克患者早期复苏治疗可应用Cv-a CO2/Ca-v O2、LCR、IVCrvi进行评估,其对复苏治疗有重要指导价值。展开更多
目的分析联合应用中心静脉-动脉二氧化碳分压差(Pcv-aCO_(2))/动脉-中心静脉氧含量差(Ca-cvO_(2))及乳酸清除率(LCR)评估脓毒症休克预后的临床价值。方法纳入2017年4月—2020年8月无锡市第九人民医院收治的脓毒症98例,依据28 d临床死亡...目的分析联合应用中心静脉-动脉二氧化碳分压差(Pcv-aCO_(2))/动脉-中心静脉氧含量差(Ca-cvO_(2))及乳酸清除率(LCR)评估脓毒症休克预后的临床价值。方法纳入2017年4月—2020年8月无锡市第九人民医院收治的脓毒症98例,依据28 d临床死亡结局分为死亡组(n=28)及对照组(n=70),收集并比较两组患者复苏6 h PcvaCO 2/Ca-cvO_(2)及LCR等临床资料。结果①本研究病死率为28.57%;②死亡组复苏6 h Pcv-aCO_(2)/Ca-cvO_(2)、急性生理与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分和序贯器官衰竭(SOFA)评分显著高于对照组(均P<0.05),但LCR显著低于对照组(P<0.05);③Pearson相关性分析提示6 h Pcv-aCO_(2)/Ca-cvO_(2)与APACHEⅡ评分和SOFA评分呈显著正相关(均P<0.05),LCR与APACHEⅡ评分和SOFA评分呈显著负相关(均P<0.05);④PcvaCO 2/Ca-cvO_(2)联合LCR预测患者病死事件的ROC曲线下面积(AUC)(95%CI)为0.89(0.82~0.96)。结论6 h Pcv-aCO_(2)/Ca-cvO_(2)及LCR在判断脓毒症休克患者预后方面有一定应用价值,值得进一步研究。展开更多
目的分析尿素氮与肌酐比值(UCR)与血乳酸清除率(LCR)预测老年重症肺炎患者死亡风险的价值。方法选择南京鼓楼医院来安分院2018年5月至2022年3月呼吸重症监护室(RICU)收治的老年重症肺炎患者83例,收集患者临床资料,根据患者入院28 d的预...目的分析尿素氮与肌酐比值(UCR)与血乳酸清除率(LCR)预测老年重症肺炎患者死亡风险的价值。方法选择南京鼓楼医院来安分院2018年5月至2022年3月呼吸重症监护室(RICU)收治的老年重症肺炎患者83例,收集患者临床资料,根据患者入院28 d的预后情况分为生存组(n=22)与死亡组(n=61)。分析老年重症肺炎患者死亡的危险因素,以及入院6 h UCR、LCR和二者联合对老年重症肺炎患者死亡风险的预测价值。结果死亡组入院时急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、年龄、入院时肺炎严重指数(PSI)分级>3级病例数占比、入院6 h超敏C反应蛋白(hs-CRP)、中性粒细胞与淋巴细胞比值(NLR)、红细胞分布宽度(RDW)、白细胞(WBC)计数和UCR高于生存组(P<0.05),入院6 h LCR低于生存组(P<0.05)。入院时PSI分级>3级、入院6 h UCR升高、LCR降低为老年重症肺炎患者死亡的危险因素(P<0.05)。入院后6 h UCR与LCR及二者联合预测老年重症肺炎患者死亡风险的曲线下面积(AUC)分别为0.715、0.701和0.805(P<0.05)。结论入院时PSI分级>3级、入院6 h UCR升高、LCR降低是老年重症肺炎患者死亡的影响因素;入院6 h UCR与LCR可用于预测老年重症肺炎患者的死亡风险,二者联合对于老年重症肺炎患者的死亡风险预测价值更高。展开更多
目的急性颅脑外伤后，患者动脉血乳酸及乳酸清除率在一定程度上反应了病情严重程度。文中旨在探讨动脉血乳酸及乳酸清除率在评估颅脑外伤患者预后的价值。方法回顾性分析南京军区南京总医院急诊科2015年2月至2015年11月收治的颅脑外伤患...目的急性颅脑外伤后，患者动脉血乳酸及乳酸清除率在一定程度上反应了病情严重程度。文中旨在探讨动脉血乳酸及乳酸清除率在评估颅脑外伤患者预后的价值。方法回顾性分析南京军区南京总医院急诊科2015年2月至2015年11月收治的颅脑外伤患者94例基本资料。在患者人院时立即进行GCS评分，动脉血乳酸、血压、心率的测定，在入院6h后再次测定动脉血乳酸浓度，计算其动脉血乳酸清除率。将所有患者分别按格拉斯哥昏迷评分分值分为轻度组（13—15分）、中度组（9—12分）和重度组（3～8分），并根据预后分为死亡组和存活组，分别比较各组的动脉血乳酸值及乳酸清除率。结果轻、中、重度3组动脉血乳酸浓度间差异有统计学意义（F=19．99，P〈0．01），且6h乳酸清除率组间差异亦有统计学意义（F=6．21，P〈0．01）。死亡组的初始血乳酸浓度明显高于存活组[（4．20±1．36）mmol／L vs（1．58±0．93）mmol／L]，差异有统计学意义（t=-9．78，P〈0．01）；死亡组的6h乳酸清除率明显低于存活组[（31．73±12．84）％ vs （46．25±12．01）％]，差异有统计学意义（t=4．55，P〈0．01）。结论在颅脑外伤的患者中，动脉血乳酸及6h乳酸清除率可较好地评估患者的病情程度及预后，在临床中具有重要应用价值。展开更多
目的探讨丹参川芎嗪注射液联合神经节苷脂对急性重度一氧化碳中毒(ASCOP)患者的疗效。方法选取2011年1月-2015年3月该院ASCOP患者329例,随机分成对照组(A组)、丹参川芎嗪注射液组(B组)、神经节苷脂组(C组)和丹参川芎嗪注射液联合神经节...目的探讨丹参川芎嗪注射液联合神经节苷脂对急性重度一氧化碳中毒(ASCOP)患者的疗效。方法选取2011年1月-2015年3月该院ASCOP患者329例,随机分成对照组(A组)、丹参川芎嗪注射液组(B组)、神经节苷脂组(C组)和丹参川芎嗪注射液联合神经节苷脂治疗组(D组),A组给予高压氧、防治脑水肿及促进脑细胞代谢等治疗;B组在常规治疗基础上加用丹参川芎嗪注射液;C组在常规治疗基础上加用神经节苷脂;D组在常规治疗基础上加用丹参川芎嗪注射液和神经节苷脂联合治疗。4组均2周为1个疗程。所有患者均于治疗前及治疗后6、24和72 h在不吸氧条件下取1 ml动脉血,检测动脉血乳酸,同时计算LCR。比较4组患者的初始血乳酸水平及6、24和72 h LCR。观察4组患者急性生理学和慢性健康状况Ⅱ(APACHEⅡ)评分、治疗2周后的临床症状改善情况、急性一氧化碳中毒迟发性脑病的发生率及病死率。结果 D组的总有效率高于A、B、C组,差异有统计学意义;4组患者入院时乳酸水平和APACHEⅡ评分比较差异无统计学意义;治疗后D组患者6和24 h LCR明显高于A、B、C组;B组与A组、C组与A组比较,差异有统计学意义(P<0.05),B组与C组比较差异无统计学意义(P>0.05);治疗后D组患者6、24和72 h急性生理学和APACHE状况Ⅱ评分低于A、B、C组,B组与A组、C组与A组比较,差异有统计学意义(P<0.05),B组与C组比较差异无统计学意义(P>0.05);治疗72 h后4组的LCR比较差异无统计学意义(P>0.05);治疗后D组患者急性一氧化碳中毒迟发性脑病的发生率和患者病死率低于A、B、C组,B组与A组、C组与A组、B组与C组比较差异无统计学意义(P>0.05)。结论丹参川芎嗪联合神经节苷脂治疗ASCOP患者能有效地提高LCR,降低急性生理学和APACHEⅡ评分,减少急性一氧化碳中毒迟发性脑病的发生率和病死率,改善患者预后,临床疗效显著,值得推广应用。展开更多
基金sponsored by Guangdong Science and Technology Project(No:2009B03081118)
文摘Objective:To explore the easily applicable indicators of practical value to evaluate the prognosis of acute respiratory distress syndrome（ARDS）.Methods:Blood and biochemical tests and bloodgas analyses were performed upon entry into the ICUs,12 h,24 h,48 h and 72 h after that in 72 ARDS patients（who were admitted to the ICUs of our hospital from January 2000 to December 2009）.Then APACHEⅡscores were achieved by combining relevant physiological parameters and laboratory results.Results:There was a statistical difference between the death group and survival group at different time points upon entering the ICUs in terms of APACHEⅡscore, alveolar-arterial oxygen difference and arterial blood lactate clearance rate.PaO<sub>2</sub>/FiO<sub>2</sub> values were recorded to be statistically different between the death group and survival group 24 h,48 h and 72 h,respectively after entry into the ICUs.In addition,registered linear regression existed between APACHEⅡscore,alveolar-arterial oxygen difference or PaO<sub>2</sub>/FiO<sub>2</sub> value and time. APACHEⅡscore 24 h and 72 h after entering ICUs predicted mortality with an area under the ROC curve（AUC） standing respectively at 0.919 and 0.9SS.Arterial blood lactate clearance rate 12 h, 24 h,48 h and 72 h after entering ICUs predicted mortality with an area under the ROC curve （AUC） at 0.918,0.918,0.909 and 0.991,respectively.Conclusions:APACHEⅡscore applied in combination with arterial blood lactate clearance rate is of clinical significance in assessing the prognosis of ARDS patients.
基金supported by the Major(Key)Science and Technology Research Project of Jinhua(Grant No.2021-3-019).
文摘Background Early evaluation of prognosis in cardiogenic shock(CS)is crucial for tailored treatment selection.Both lactate clearance and lactate levels are considered useful prognostic biomarkers in patients with CS.However,there is yet no literature comparing the 6-hour lactate clearance rate(Δ6Lac)with lactate levels measured at admission(L1)and after 6 h(L2)to predict 30-day mortality in CS.Methods In this observational cohort study,95 patients with CS were treated at Department of Intensive Care Unit,Yiwu Central Hospital between January 2020 and December 2022.Of these,88 patients met the eligibility criteria.The lactate levels were measured after admission(L1)as the baseline lactate value,and were measured after 6 h(L2)following admission.The primary endpoint of the study was survival rate at 30 days.A receiver operating characteristic curve was used for data analysis.Univariate and multivariate Cox regression analyses were performed based onΔ6Lac.Kaplan–Meier(KM)survival curves were generated to compare the 30-day survival rates among L1,L2,andΔ6Lac.Results TheΔ6Lac model showed the highest area under the curve value(0.839),followed by the L2(0.805)and L1(0.668)models.TheΔ6Lac model showed a sensitivity of 84.2%and specificity of 75.4%.The L1 and L2 models had sensitivities of 57.9%each and specificities of 89.9%and 98.6%,respectively.The cut-off values forΔ6Lac,L1,and L2 were 18.2%,6.7 mmol/L,and 6.1 mmol/L,respectively.Univariate Cox regression analysis revealed a significant association betweenΔ6Lac and 30-day mortality.After adjusting for five models in multivariate Cox regression,Δ6Lac remained a significant risk factor for 30-day mortality in patients with CS.In our fifth multivariate Cox regression model,Δ6Lac remained a risk factor associated with 30-day mortality(hazard ratio[HR]=5.14,95%confidence interval[CI]:1.48 to 17.89,P=0.010)as well as L2(HR=8.42,95%CI:1.26 to 56.22,P=0.028).The KM survival curve analysis revealed that L1>6.7 mmol/L(HR=8.08,95%CI:3.23 to 20.20,P<0.001),L2>6.1 mmol/L(HR=25.97,95%CI:9.76 to 69.15,P<0.001),andΔ6Lac≤18.2%(HR=8.92,95%CI:2.95 to 26.95,P<0.001)were associated with a higher risk of 30-day mortality.ConclusionsΔ6Lac is a better predictor for 30-day mortality in CS than lactate levels at admission.It has a predictive value equivalent to that of lactate level at 6 h after admission,making it an important surrogate indicator for evaluating the suitability as well as poor prognosis after CS treatment.We found that a cut-off value of 18.2%forΔ6Lac provided the most accurate assessment of early prognosis in CS.
文摘目的探讨静脉-动脉二氧化碳含量差/动脉-静脉氧含量差(Cv-a CO2/Ca-v O2)、乳酸清除率(LCR)与下腔静脉内径呼吸变异指数(IVCrvi)作为脓毒症休克患者早期复苏终点指标的可行性及价值。方法选取2016年6月至2018年2月该院收治的脓毒性休克患者60例,均进行早期液体复苏治疗,应用Cv-a CO2/Ca-v O2、LCR、IVCrvi进行评估,以尿量大于0.5 m L/(kg·h)、平均动脉压大于65 mm Hg(1 mm Hg=0.133 k Pa)为达标,根据达标情况将患者分为达标组和未达标组。结果复苏治疗后所有患者Cv-a CO2/Ca-v O2、LCR及IVCrvi等指标均得到明显改善,达标组患者指标改善情况优于未达标组,差异均有统计学意义(P<0.05)。结论脓毒症休克患者早期复苏治疗可应用Cv-a CO2/Ca-v O2、LCR、IVCrvi进行评估,其对复苏治疗有重要指导价值。
文摘目的分析联合应用中心静脉-动脉二氧化碳分压差(Pcv-aCO_(2))/动脉-中心静脉氧含量差(Ca-cvO_(2))及乳酸清除率(LCR)评估脓毒症休克预后的临床价值。方法纳入2017年4月—2020年8月无锡市第九人民医院收治的脓毒症98例,依据28 d临床死亡结局分为死亡组(n=28)及对照组(n=70),收集并比较两组患者复苏6 h PcvaCO 2/Ca-cvO_(2)及LCR等临床资料。结果①本研究病死率为28.57%;②死亡组复苏6 h Pcv-aCO_(2)/Ca-cvO_(2)、急性生理与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分和序贯器官衰竭(SOFA)评分显著高于对照组(均P<0.05),但LCR显著低于对照组(P<0.05);③Pearson相关性分析提示6 h Pcv-aCO_(2)/Ca-cvO_(2)与APACHEⅡ评分和SOFA评分呈显著正相关(均P<0.05),LCR与APACHEⅡ评分和SOFA评分呈显著负相关(均P<0.05);④PcvaCO 2/Ca-cvO_(2)联合LCR预测患者病死事件的ROC曲线下面积(AUC)(95%CI)为0.89(0.82~0.96)。结论6 h Pcv-aCO_(2)/Ca-cvO_(2)及LCR在判断脓毒症休克患者预后方面有一定应用价值,值得进一步研究。
文摘目的分析尿素氮与肌酐比值(UCR)与血乳酸清除率(LCR)预测老年重症肺炎患者死亡风险的价值。方法选择南京鼓楼医院来安分院2018年5月至2022年3月呼吸重症监护室(RICU)收治的老年重症肺炎患者83例,收集患者临床资料,根据患者入院28 d的预后情况分为生存组(n=22)与死亡组(n=61)。分析老年重症肺炎患者死亡的危险因素,以及入院6 h UCR、LCR和二者联合对老年重症肺炎患者死亡风险的预测价值。结果死亡组入院时急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、年龄、入院时肺炎严重指数(PSI)分级>3级病例数占比、入院6 h超敏C反应蛋白(hs-CRP)、中性粒细胞与淋巴细胞比值(NLR)、红细胞分布宽度(RDW)、白细胞(WBC)计数和UCR高于生存组(P<0.05),入院6 h LCR低于生存组(P<0.05)。入院时PSI分级>3级、入院6 h UCR升高、LCR降低为老年重症肺炎患者死亡的危险因素(P<0.05)。入院后6 h UCR与LCR及二者联合预测老年重症肺炎患者死亡风险的曲线下面积(AUC)分别为0.715、0.701和0.805(P<0.05)。结论入院时PSI分级>3级、入院6 h UCR升高、LCR降低是老年重症肺炎患者死亡的影响因素;入院6 h UCR与LCR可用于预测老年重症肺炎患者的死亡风险,二者联合对于老年重症肺炎患者的死亡风险预测价值更高。
文摘目的急性颅脑外伤后，患者动脉血乳酸及乳酸清除率在一定程度上反应了病情严重程度。文中旨在探讨动脉血乳酸及乳酸清除率在评估颅脑外伤患者预后的价值。方法回顾性分析南京军区南京总医院急诊科2015年2月至2015年11月收治的颅脑外伤患者94例基本资料。在患者人院时立即进行GCS评分，动脉血乳酸、血压、心率的测定，在入院6h后再次测定动脉血乳酸浓度，计算其动脉血乳酸清除率。将所有患者分别按格拉斯哥昏迷评分分值分为轻度组（13—15分）、中度组（9—12分）和重度组（3～8分），并根据预后分为死亡组和存活组，分别比较各组的动脉血乳酸值及乳酸清除率。结果轻、中、重度3组动脉血乳酸浓度间差异有统计学意义（F=19．99，P〈0．01），且6h乳酸清除率组间差异亦有统计学意义（F=6．21，P〈0．01）。死亡组的初始血乳酸浓度明显高于存活组[（4．20±1．36）mmol／L vs（1．58±0．93）mmol／L]，差异有统计学意义（t=-9．78，P〈0．01）；死亡组的6h乳酸清除率明显低于存活组[（31．73±12．84）％ vs （46．25±12．01）％]，差异有统计学意义（t=4．55，P〈0．01）。结论在颅脑外伤的患者中，动脉血乳酸及6h乳酸清除率可较好地评估患者的病情程度及预后，在临床中具有重要应用价值。
文摘目的探讨丹参川芎嗪注射液联合神经节苷脂对急性重度一氧化碳中毒(ASCOP)患者的疗效。方法选取2011年1月-2015年3月该院ASCOP患者329例,随机分成对照组(A组)、丹参川芎嗪注射液组(B组)、神经节苷脂组(C组)和丹参川芎嗪注射液联合神经节苷脂治疗组(D组),A组给予高压氧、防治脑水肿及促进脑细胞代谢等治疗;B组在常规治疗基础上加用丹参川芎嗪注射液;C组在常规治疗基础上加用神经节苷脂;D组在常规治疗基础上加用丹参川芎嗪注射液和神经节苷脂联合治疗。4组均2周为1个疗程。所有患者均于治疗前及治疗后6、24和72 h在不吸氧条件下取1 ml动脉血,检测动脉血乳酸,同时计算LCR。比较4组患者的初始血乳酸水平及6、24和72 h LCR。观察4组患者急性生理学和慢性健康状况Ⅱ(APACHEⅡ)评分、治疗2周后的临床症状改善情况、急性一氧化碳中毒迟发性脑病的发生率及病死率。结果 D组的总有效率高于A、B、C组,差异有统计学意义;4组患者入院时乳酸水平和APACHEⅡ评分比较差异无统计学意义;治疗后D组患者6和24 h LCR明显高于A、B、C组;B组与A组、C组与A组比较,差异有统计学意义(P<0.05),B组与C组比较差异无统计学意义(P>0.05);治疗后D组患者6、24和72 h急性生理学和APACHE状况Ⅱ评分低于A、B、C组,B组与A组、C组与A组比较,差异有统计学意义(P<0.05),B组与C组比较差异无统计学意义(P>0.05);治疗72 h后4组的LCR比较差异无统计学意义(P>0.05);治疗后D组患者急性一氧化碳中毒迟发性脑病的发生率和患者病死率低于A、B、C组,B组与A组、C组与A组、B组与C组比较差异无统计学意义(P>0.05)。结论丹参川芎嗪联合神经节苷脂治疗ASCOP患者能有效地提高LCR,降低急性生理学和APACHEⅡ评分,减少急性一氧化碳中毒迟发性脑病的发生率和病死率,改善患者预后,临床疗效显著,值得推广应用。
