脓毒性休克患者血乳酸清除率与预后的相关性研究  

study on the correlation between the prognosis and the early lactate clearance rate in patients with septic shock

作　　者：王洪武[1] 李景辉[1] 邓超[1] 

机构地区：[1]海口市人民医院重症医学科,海南海口570208

出　　处：《现代预防医学》2012年第16期4330-4331,共2页Modern Preventive Medicine

摘　　要：目的探讨早期血乳酸清除率在脓毒性休克患者预后评估中的相关性。方法检测86例脓毒性休克患者0h(以诊断休克为研究起点)、6h动脉血乳酸水平,计算6h乳酸清除率。以好转或死亡为研究终点,按预后不同将患者分为存活组(n=52)和死亡组(n=34);以乳酸清除率10%为标准分为高乳酸清除率组(≥10%,n=61)和低乳酸清除率组(﹤10%,n=25),比较存活组与死亡组、高乳酸清除率组与低乳酸清除率组之间相关数值的差异。结果存活组6h血乳酸清除率为(30.5±18.0)%,显著高于死亡组(11.2±13.1)%,P﹤0.01;高乳酸清除率组病死率(27.9%)低于低乳酸清除率组(64.0%),P﹤0.01。结论早期乳酸清除率可作为脓毒性休克患者判断预后转归的一个很好指标。OBJECTIVE To evaluate the correlation between the prognosis and the early lactate clearance rate in patients with septic shock. METHODS Blood concentration of 0-hour lactate （diagnosis of shock as study starting point） and 6-hours lactate were detected in 86 patients with septic shock, and 6-hour lactate clearance rate were calculated. Improvement or death was re- garded as the endpoint of the study, and they were divided into survival group （n = 52） and dead group （n = 34） according to the prognosis. The rate of lactate clearance was determined at the cut-point of 10%, and patients were divided into low lactate clearance group （ 〈 10%, n = 25） and high lactate clearance group （≥ 10%, n = 61 ）. The difference between the two groups were compared. RESULTS The early lactate clearance rate in survival group （30.5± 18.0） % was significantly higher than that in death group （11.2 ± 13.1） % （P〈 0.01）. The mortality in high lactate clearance group was significantly less than that in the low lactate group （27.9% vs 64.0%, P 〈 0.01）. CONCLUSION The early lactate clearance is a good prognostic factor of septic shock.

关 键 词：脓毒性休克 乳酸清除率 预后 

分 类 号：R441.9[医药卫生—诊断学]