摘要
目的探讨乳酸(LAC)与中心静脉血氧饱和度(ScvO_2)的比值(LAC/ScvO_2)对休克患者病情判断的应用价值。方法休克患者64例,以入院后28 d是否死亡分为生存组35例和死亡组29例。比较2组性别、年龄、LAC/ScvO_2、LAC、6 h乳酸清除率(6 h-LCR)、ScvO_2、急性生理与慢性健康评分系统Ⅱ(APACHEⅡ)评分的差异;分析LAC/ScvO_2与APACHEⅡ评分的相关性;ROC曲线分析LAC/ScvO_2、LAC、6 h-LCR、ScvO_2、APACHEⅡ评分对休克治疗和预后评判的价值。结果 2组LAC、ScvO_2、6 h-LCR、APACHEⅡ评分差异有统计学意义,生存组LAC/ScvO_2低于死亡组(P<0.01)。LAC/ScvO_2与APACHEⅡ评分呈正相关(rs=0.706,P<0.01)。相对于LAC、ScvO_2、6 h-LCR、APACHEⅡ评分,LAC/ScvO_2敏感度和特异度均最高,最佳临界值为13.92。结论 LAC/ScvO_2是休克患者病情危重程度及预后评估较好的指标。
Objective To investigate the application value of the ratio of lactic acid（LAC）divided by central venousoxygen saturation（ScvO2） to judge the illness severity and prognosis in shock patients. Methods Sixty-four shock patientswere divided into two groups： survival group（n=35） and death group（n=29） based on death in 28-d admission. The gender,age, LAC/ScvO2, LAC, 6 h-lactate clearance rate（6 h-LCR）, ScvO2 and acute physiology and chronic health Ⅱ（APACHEⅡ） score were compared between two groups. The correlation of LAC/ScvO_2 with APACHEⅡscore was analysised in twogroups. The receiver operating characteristic（ROC） curve was used to analyse the values of LAC/ScvO_2, LAC, 6 h-LCR,ScvO_2 and APACHEⅡscore in the treatment and prognosis of shock. Results There were significant differences in LAC,ScvO_2, 6h-LCR and APACHE Ⅱbetween two groups. There was a lower LAC/ScvO2 in survival group compared with that ofdeath group（P〈0.01）. LAC/ScvO2 was positively correlated with APACHE Ⅱ score（rs=0.706,P〈0.01）. The sensitivity andspeciality of LAC/ScvO2 were the highest compared with those of LAC, ScvO2, 6 h-LCR and APACHEⅡ score, the bestthreshold was 13.92. Conclusion LAC/ScvO2 is a better indicator for shock patients to evaluate the severity degree andprognosis.
出处
《天津医药》
CAS
2016年第3期360-362,共3页
Tianjin Medical Journal
