摘要
目的:探讨早期动脉血乳酸清除率对脓毒症休克患者预后的评估,与APACHEⅡ评分、SOFA评分的比较。方法:回顾性收集我科室2015-07-2016-08期间78例感染性休克患者的临床资料,根据患者住院28d转归,将患者分为生存组和死亡组。根据ROC曲线,分析6h动脉血乳酸清除率,寻找出最佳截断值,根据最佳截断值分为高乳酸清除率组及低乳酸清除率组,分析2组乳酸、APACHEⅡ评分、SOFA评分及病死率之间的差异。结果:研究收集78例感染性休克患者,其中存活44例,死亡34例。存活组和死亡组:入院动脉血乳酸水平、APACHEⅡ评分、SOFA评分及早期乳酸清除率差异均有统计学意义(P<0.05)。早期乳酸清除率、APACHEⅡ评分及SOFA评分ROC曲线下面积分别为0.649、0.793、0.881。最高约登指数0.60时,对应的早期乳酸清除率为29%时,以此分为高乳酸清除率组和低乳酸清除率组,2组APACHEⅡ评分、SOFA评分及预后差异均有统计学意义(P<0.01)。结论:早期乳酸清除率可作为判断感染性休克患者预后的指标。
Objective：Investigate the arterial blood lactate clearance rate to evaluate the prognostic of patients with sepsis shock.Blood lactate clearance rate and APACHEⅡ scores,the relationship between SOFA score.Method：Retrospectively collected my department in July 2015 to August 2016,the clinical data of 78 patients with septic shock,according to the prognosis of patients can be divided into survival group and death group.According to the ROC curve analysis of 6harterial blood lactate clearance rate,find out the best cut off value,according to the optimal cutoff value is divided into high lactate clearance rate and low lactate clearance group,analysis of two groups of lactic acid,APACHEⅡ scores,the difference between SOFA score and mortality.Result：Research collected 78 cases of patients with septic shock,live 44 cases,34cases of death.Survival group and death group：admission blood lactic acid level,APACHEⅡ scores,SOFA score and early lactate clearance rate difference had statisticalsignificance（P〈0.05）.Early lactate clearance rate and APACHEⅡ scores and SOFA score area under the ROC curve were 0.649,0.793,0.881,respectively.Highestabout an index of 0.60,corresponding to the early lactate clearance rate was 29%,which is divided into high lactate clearance rate and low lactate clearance group,twogroups of APACHEⅡ scores,SOFA grading and prognosis were significant differences（P〈0.01）.Conclusion：Early lactate clearance rate can be used as an index of judging the prognosis ofpatients with septic shock.
出处
《临床急诊杂志》
CAS
2016年第12期930-931,934,共3页
Journal of Clinical Emergency
关键词
乳酸
乳酸清除率
感染性休克
预后
lactate
lactate clearance rate
sepsis shock
prognostic
