早期乳酸清除率在严重脓毒症、脓毒性休克患者预后评估中的应用价值  

Application value of early lactic acid clearance in prognosis assessment of patients with severe sepsis and septic shock

作　　者：王吉 WANG Ji(Department of Intensive Care Medicine,Yangzhou Hongquan Hospital,Yangzhou 225200,China)

机构地区：[1]江苏省扬州洪泉医院重症医学科,江苏扬州225200

出　　处：《当代医药论丛》2023年第5期103-106,共4页

摘　　要：目的:探讨早期乳酸清除率在严重脓毒症、脓毒性休克患者预后评估中的应用价值。方法:选取在江苏省扬州洪泉医院ICU接受诊治的严重脓毒症、脓毒性休克患者65例,按照预后差异分为存活组(42例)和死亡组(23例);比较两组患者的血清乳酸浓度、乳酸清除率、急性生理与慢性健康评分(APACHEⅡ评分)、脓毒症相关序贯器官衰竭评分(SOFA评分),观察各指标预测患者预后结局的效果。结果:存活组入院后6 h的血清乳酸水平低于死亡组,P<0.05。存活组的早期乳酸清除率高于死亡组,P<0.05。存活组的APACHEⅡ评分、SOFA评分均低于死亡组,P<0.05。经绘制ROC曲线后得出,入院时血清乳酸水平、入院后6 h血清乳酸水平、早期乳酸清除率、APACHEⅡ评分、SOFA评分预测患者死亡结局的AUC分别为0.518、0.897、0.924、0.791、0.881。早期乳酸清除率预测患者死亡的灵敏度高于入院时血清乳酸水平、APACHEⅡ评分,其预测患者死亡的特异度、AUC均高于入院时血清乳酸水平、入院后6 h血清乳酸水平、APACHEⅡ评分、SOFA评分。结论:早期乳酸清除率能够有效评估严重脓毒症、脓毒性休克患者的预后结局。Objective:To investigate the application value of early lactic acid clearance in prognosis assessment of patients with severe sepsis and septic shock.Methods:Sixty-five patients with severe sepsis and septic shock admitted to the ICU of Hongquan Hospital in Yangzhou,Jiangsu Province were selected and divided into survival group(42 cases)and death group(23 cases)according to the difference in prognosis.The serum lactate concentration,lactate clearance rate,acute physiological and chronic health score(APACHEⅡscore),and sepsis related sequential organ failure score(SOFA score)of the two groups were compared to observe the effect of each index in predicting the outcome of the patients.Results:The serum lactate level of the survival group was lower than that of the death group at 6 h after admission,P<0.05.The early lactic acid clearance rate in survival group was higher than that in death group,P<0.05.APACHEⅡscore and SOFA score of survival group were lower than those of death group,P<0.05.After ROC curve was drawn,the AUCs of serum lactate level at admission,serum lactate level at 6 h after admission,early lactate clearance rate,APACHEⅡscore and SOFA score for predicting death outcome of patients were 0.518,0.897,0.924,0.791 and 0.881,respectively.The sensitivity of early lactate clearance in predicting death was higher than that of serum lactate level and APACHEⅡscore at admission,and the specificity and AUC in predicting death were higher than that of serum lactate level at admission,serum lactate level at 6 h after admission,APACHEⅡscore and SOFA score.Conclusion:Early lactate clearance can effectively evaluate the prognosis of patients with severe sepsis and septic shock.

关 键 词：早期乳酸清除率 严重脓毒症 脓毒性休克 预后 

分 类 号：R446[医药卫生—诊断学]