急性呼吸窘迫综合征患者乳酸清除率及APACHEⅡ评分的动态变化及临床意义  

Dynamic Changes and Clinical Significance of Lactate Clearance Rate and APACHEⅡ Score in Patients with Acute Respiratory Distress Syndrome

作　　者：章文豪[1] 王翔[1] 孙芳[1] 徐巧莲[1] 孙加奎[1] 邹磊[1] ZHANG Wenhao;WANG Xiang;SUN Fang;XU Qiaolian;SUN Jiakui;ZOU Lei(Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院南京市第一医院南京

出　　处：《中外医学研究》2020年第1期13-15,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：2014年度南京市医学科技发展项目（项目编号：ZKX14036）

摘　　要：目的:探索急性呼吸窘迫综合征患者乳酸清除率及APACHEⅡ评分的动态变化及临床意义。方法:从笔者所在医院2016年1月-2018年12月收治的ARDS患者中选择80例作为研究对象,按照相关要求治疗28 d后,根据患者生存情况将患者分为生存组(n=48)和死亡组(n=32),分别于治疗1、3、7、14、21 d计算患者乳酸清除率及APACHEⅡ评分。结果:生存组患者乳酸清除率先增高后减低,死亡组患者乳酸清除率则持续降低,两组治疗1 d乳酸清除率比较差异无统计学意义(P>0.05),治疗3、7、14、21 d两组比较差异均有统计学意义(P<0.05),APACHEⅡ评分生存组逐渐降低,死亡组逐渐增高,两组治疗1 d的APACHEⅡ评分比较差异无统计学意义(P>0.05),治疗3、7、14、21 d比较差异均有统计学意义(P<0.05)。结论:动态监测患者乳酸清除率及APACHEⅡ评分可及时准确地反映患者病情及预后,可在临床上推广应用。Objective:To explore the dynamic changes and clinical significance of lactate clearance rate and APACHEⅡscore in patients with acute respiratory distress syndrome.Method:Eighty patients with ARDS admitted to our hospital from January 2016 to December 2018 were selected as the study subjects.After 28 days of treatment according to the relevant requirements,the patients were divided into survival group(n=48)and death group(n=32).The lactate clearance rate and APACHEⅡscores were calculated on 1,3,7,14 d and 21 d of treatment,respectively.Result:The clearance rate of lactate in survival group increased first and then decreased,while that in death group continued to decrease.There was no significant difference in clearance rate of lactate on 1 d of treatment(P>0.05).There were significant differences in clearance rate of lactate at 3,7,14 and 21 days of treatment between the two groups(P<0.05).APACHEⅡscore decreased gradually in survival group,and increased gradually in death group,and there was no significant difference on 1 d of treatment(P>0.05).There were significant differences in clearance rate of lactate on 3,7,14 and 21 days of treatment(P<0.05).Conclusion:Dynamic monitoring of lactate clearance rate and APACHEⅡscore can timely and accurately reflect the patients’condition and prognosis,and can be widely used in clinical practice.

关 键 词：急性呼吸窘迫综合征 乳酸清除率 APACHEⅡ评分 缺氧 乳酸 

分 类 号：R563.8[医药卫生—呼吸系统]