危重患者血乳酸水平和清除率与预后的关系  

Relationship between blood lactate and lactate clearance rate with prognosis in critical ill patients

作　　者：张朝贵[1] 杨宗勇[2] 张春林[1] 

机构地区：[1]宜宾市第二人民医院ICU,四川宜宾644000 [2]宜宾市第一人民医院药剂科,四川宜宾644000

出　　处：《四川医学》2012年第4期645-647,共3页Sichuan Medical Journal

摘　　要：目的探讨危重患者血乳酸水平和清除率与预后的关系。方法对129例ICU危重患者入住ICU时行动脉血乳酸水平测定,6h和24h再次测定血乳酸水平,并计算6h和24h乳酸清除率。将患者分成存活组和死亡组;根据乳酸清除率的高低分为高乳酸清除率组(6h乳酸清除率≥10%)和低乳酸清除率组(6h乳酸清除率<10%),比较各组间的差异。结果各组年龄和初始血乳酸水平比较差异无统计学意义(P>0.05);存活组6h和24h乳酸清除率明显高于死亡组[(45.25±12.52)%VS(8.53±11.21)%和(78.27±21.53)%VS(-10.63±8.22)%,P<0.01];高乳酸清除率组病死率明显低于低乳酸清除率组(20.0%VS 51.0%,P<0.01)。结论血乳酸水平和乳酸清除率是反映危重患者病情严重程度和预后的较好指标。Objective To explore the correlation between the prognosis and the blood lactate and lactate clearance rate in critical ill patients.Methods The data of 129 critical ill patients were collected,including blood lactate after admission to ICU,the blood lactate and lactate clearance rate after 6 hours and 12 hours in ICU.A total of 129 cases were divided into survival group and dead group,low lactate clearance rate group and high lactate clearance rate group,and the differences between them were compared for statistical significance.Results There were no differences in age and the initial blood concentration of lactate（P0.05）;The lactate clearance rate after 6 hours and 12 hours in survival group was significantly higher than it in dead group[（45.25±12.52）% VS（8.53±11.21）% and（78.27±21.53）% VS（-10.63±8.22）%,P0.01];The mortality in high lactate clearance rate group was significantly lower than it in the low lactate clearance rate group（20.0% VS 51.0 %,P0.01）.Conclusion Blood lactate and lactate clearance rate can be regarded as good indicators to evaluate the severe degree and to predict the prognosis of critical ill patients.

关 键 词：危重患者 乳酸 乳酸清除率 预后 

分 类 号：R459.7[医药卫生—急诊医学]