血乳酸清除率与APACHE Ⅱ评分在感染性休克患者中的相关性探讨

摘要

Objective To explore the correlation between lactate clearance rate and APACHE Ⅱ score in patients with septic shock. Methods According to the APACHE Ⅱ scores, 85 patients with septic shock treated in our hospital were divided into group A (APACHE Ⅱ score ≥20, n＝44) and group B (APACHE Ⅱ score ＜20, n＝41). The lactate levels and APACHEⅡscores of the two groups were compared. The lactate levels, lactate clearance rate and APACHE Ⅱ scores of survived cases and dead cases were compared. Results The lactate levels and APACHE Ⅱ scores of group A were (13.76±4.55) mmol/L and (32.37±8.80), which were significantly higher than those of group B numbered as (5.41±1.78) mmol/L and (16.44±3.06) (P＜0.05). The lactate levels, APACHE Ⅱ scores and lactate clearance rate of dead cases were (13.66±5.92) mmol/L, (37.12±10.66) and (3.08±1.22) %, which were significantly worse than those of survived cases numbered as (7.65±3.70) mmol/L, (18.58±7.07) and (11.25±4.71) % (P＜0.05). In both dead cases and survived cases, the lactate clearance rate and APACHE Ⅱ scores showed significant negative correlation (P＜0.05). Conclusion In patients with septic shock, the lactate clearance rate and APACHE Ⅱ scores showed significant negative correlation. The two parameters can be the index of disease condition and prognosis. Treatment protocol can be established according to the levels of the lactate clearance rate and APACHE Ⅱ scores.%目的 探讨血乳酸清除率与APACHE Ⅱ评分在感染性休克患者中的相关性.方法 85 例入院治疗的感染性休克患者根据其APACHE Ⅱ评分分成A组(≥20 分)44 例与B组(＜20 分)41 例,比较两组患者血乳酸水平以及APACHE Ⅱ评分情况.另外比较存活患者与死亡患者血乳酸水平、APACHE Ⅱ评分以及血乳酸清除率情况.结果 A组患者的血乳酸水平与APACHE Ⅱ评分分别为(13.76±4.55)mmol/L与(32.37±8.80),均显著高于B组的(5.41±1.78)mmol/L与(16.44±3.06) (P＜0.05).死亡患者的血乳酸水平、APACHE Ⅱ评分、血乳酸清除率分别为(13.66±5.92)mmol/L、(37.12±10.66)与(3.08±1.22)%,均显著差于存活患者的(7.65±3.70)mmol/L、(18.58±7.07)与(11.25±4.71)%(P＜0.05).死亡患者与存活患者中,血乳酸清除率与APACHEⅡ评分均呈现明显的负相关(P＜0.05).结论 在感染性休克患者中,APACHE Ⅱ评分与血乳酸清除率呈现负相关,两者可以作为评估感染性休克患者病情及预后的指标,并根据其水平制定合理的治疗方案.