碱剩余差值及乳酸清除率用于评估ICU成人休克患者预后的价值

摘要

目的 探讨碱剩余差值及乳酸清除率用于评估I C U成人休克患者预后的价值.方法 对2017年1—11月沈阳医学院附属中心医院I C U收治的36例成人休克患者的临床资料进行回顾性分析,依据患者是否死亡进行分组,并分析患者入ICU 12 h的碱剩余差值及乳酸清除率评估其预后的价值.结果 存活组和死亡组患者入ICU时及入ICU12 h的碱剩余、动脉血乳酸水平差异无统计学意义(P＞0.05);存活组患者入ICU 12 h的碱剩余、动脉血乳酸水平与入ICU时差异均有统计学意义(P＜0.05);死亡组患者入ICU 12 h的碱剩余、动脉血乳酸水平与入ICU时差异均无统计学意义(P＞0.05);存活组与死亡组入ICU 12 h的碱剩余差值、乳酸清除率差异均有统计学意义(P＜0.05);入ICU 12 h的碱剩余差值与乳酸清除率呈负相关;入ICU 12 h碱剩余差值及乳酸清除率对ICU成人休克患者死亡预测的ROC曲线下面积分别为0.785和0.867.结论 ICU成人休克患者入ICU 12 h的碱剩余差值及乳酸清除率能很好地用于评估其预后.%Objective To evaluate the value of base excess difference and lactate clearance rate in the prognosis of adult patients with shock in ICU.Methods The clinical data of 36 adult patients with shock in ICU in Central Hospital Affiliated to Shenyang Medical College from January to November 2017 were analyzed retrospectively.The patients were divided into survival group and death group,and the value of base excess difference and lactate clearance rate between two groups were analyzed to evaluate the prognosis.Results There was no significant difference between survival group and death group in base excess and arterial blood lactate when admitted into ICU and 12 hours after admission(P > 0.05).The difference in base excess and arterial blood lactate between admitted ICU and after 12 hours admitted into ICU was significant different in survival group(P < 0.05).There was no significant difference in base excess and arterial blood lactate between admitted ICU and after 12 hours admitted into ICU in death group(P > 0.05).There were significant differences in base excess difference and lactate clearance rate after 12 hours admitted into ICU between survival group and death group (P < 0.05).After 12 hours admitted into ICU,the base excess difference were negatively correlated with lactate clearance rate.The areas under the ROC curves of base excess difference and lactate clearance rate were 0.785 and 0.867 for prediction of death in shock patients,respectively.Conclusion The base excess difference and lactate clearance rate after 12 hours admitted into ICU are good markers for evaluating the prognosis of shock patients in ICU.