乳酸清除率在甲型H1N1流感危重症患者预后评估中的应用  

Prognosis of severe A/H1N1 influenza patients assessed by lactate clearance rate

作　　者：杜庆[1] 周明香[1] 王光强[1] 孙文青[1] 李春梅[1] 李磊[1] 吕宝[1] 肖长国[1] 蔡福红 

机构地区：[1]山东省胸科医院东院ICU,山东济南250101

出　　处：《临床肺科杂志》2011年第3期338-339,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨甲型H1N1流感危重症患者动脉乳酸及乳酸清除率的变化与预后的关系。方法对我院收治的43例甲型H1N1流感危重症患者测定入院和入院12 h动脉乳酸,计算12 h乳酸清除率。根据24 h内最差生命体征、生化指标、年龄及是否手术计算APACHEⅡ。据患者预后分为存活组和死亡组,比较两组动脉乳酸及12h乳酸清除率;据APACHEⅡ分为≤20分组及>20分组,比较两组动脉乳酸及乳酸清除率;用Pearson相关分析APACHEⅡ与动脉乳酸相关性。结果 APACHEⅡ>20分组较≤20分组初始动脉乳酸升高,有统计学差异(P<0.05);线性相关分析示初始动脉乳酸与APACHEⅡ呈正相关(r=0.487,P<0.05)。死亡组APACHEⅡ评分明显高于存活组,死亡组患者乳酸清除率明显低于存活组,有统计学差异(P<0.05)。结论随着APACHEⅡ评分的增高,动脉乳酸也相应增高,且12 h动脉乳酸清除率低者,病情严重预后愈差。Objective Observe change of arterial blood lactic acid and its 12 h clearance in patients with A/H1N1 influenza,discuss of clinical significance on prognosis.Methods The 43 patients were collected for LAC detect,monitor it when admitted and after 12 h,calculate clearance.We collected clinical variables in 24 hours,calculate APACHEⅡ.Patients were divided into20 and≤20 score group,calculate difference of LAC and 12 h clearance.We calculate correlation of APACHEⅡand LAC with liner regressi on.Patients were divided into dead and survival group.Calculate LAC and 12 h clearance of two groups.Results LAC of APACHEⅡ20 group was higher,and 12 h clearance was lower;Pearson correlation proved LAC was positive correlated with APACHEⅡ,while 12 h clearance was negative.There are significant difference in LAC and its clearance,LAC of dead group is higher obviously.Conclusion The higher APACHEⅡand LAC,the lower 12 h LAC clearance,the worse the prognosis.LAC can be used as an excellent prognosis index for A/H1N1 influenza patients.

关 键 词：甲型H1N1流感 动脉乳酸 乳酸清除率 APACHEⅡ评分 

分 类 号：R511.7[医药卫生—内科学]