血清乳酸脱氢酶及血乳酸清除率对急性胰腺炎预后的评估  

The Evaluation of Serum Lactate Dehydrogenase and Early Blood Lactate Clearance Rate on the Prognosis of Patients with Acute Pancreatitis

作　　者：顾玲玲 张辉 GU Ling-ling;ZHANG Hui(Department of Emergency and Critical Care Medicine,Suzhou Municipal Hospital,Suzhou,Jiangsu,215002,China)

机构地区：[1]南京医科大学附属苏州医院,苏州市立医院急危重症医学科,江苏苏州215002

出　　处：《中国血液流变学杂志》2020年第4期455-458,共4页Chinese Journal of Hemorheology

摘　　要：目的研究血清乳酸脱氢酶(LDH)及早期血乳酸清除率对急性胰腺炎(AP)患者预后的评估.方法回顾性分析2018年05月—2020年09月苏州市立医院本部急诊内科及重症监护室收治的49例AP患者的临床资料.根据有无继发多脏器功能不全综合征(MODS)分为非MODS组及MODS组,根据入院28 d内其死亡结局分为存活组及死亡组,分别比较两组间LDH水平及乳酸清除率;采用APACHEⅡ评分评价患者预后,统计分析LDH含量、乳酸清除率与预后的相关性.结果(1)各组间其性别、年龄、发病病因等指标差异无统计学意义(P>0.05);(2)MSAP组、SAP组患者LDH水平明显高于MAP组,而6 h乳酸清除率明显低于MAP组,差异有统计学意义(P<0.05);(3)MODS组、死亡组AP患者LDH水平明显高于非MODS组、存活组,而6 h乳酸清除率明显低于非MODS组、存活组,差异有统计学意义(P<0.05);(4)AP患者的APACHEⅡ评分与LDH水平呈正相关(r=0.498),与6 h乳酸清除率呈负相关(r=-0.655),差异有统计学意义(P<0.05).结论早期血乳酸清除率和LDH对AP患者预后的评估有较大价值.Objective To evaluate the serum lactate dehydrogenase(LDH)and early blood lactate clearance rate on the prognosis of patients with acute pancreatitis(AP).Methods A retrospective analysis was performed on the clinical data of 49 AP patients admitted to the Emergency Department and Intensive Care Unit of Suzhou Municipal Hospital from May 2018 to September 2020.According to the presence or absence of secondary multiple organ dysfunction syndrome(MODS),they were divided into non-MODS group and MODS group.According to the death outcomes within 28 days of admission,they were divided into survival group and death group.LDH levels and lactate clearance rates between the two groups were compared respectively;The APACHE Ⅱ score was used to evaluate the prognosis of patients,and the correlation between LDH content,lactate clearance rate and prognosis was statistically analyzed.Results 1.There was no significant difference in gender,age,etiology and other indicators among the groups(P>0.05);2.The LDH level of patients in the MSAP and SAP groups was significantly higher than that of the MAP group,while the 6 h lactate clearance rate was significantly lower than that of the MAP group.There is statistical significance(P<0.05);3.The LDH level of AP patients in the MODS group and the death group was significantly higher than that of the non-MODS group and the survival group,while the 6 h lactate clearance rate was significantly lower than that of the non-MODS group and the survival group,and the difference was statistically significant(P<0.05);4.The APACHE II score of AP patients was positively correlated with LDH level(r=0.498),and negatively correlated with 6 h lactate clearance(r=—0.655),the difference was statistically significant(P<0.05).Conclusion Early blood lactate clearance rate and LDH are of great value in the evaluation of the prognosis of patients with AP.

关 键 词：急性胰腺炎 乳酸清除率 乳酸脱氢酶 多脏器功能不全综合征 

分 类 号：R576[医药卫生—消化系统]