乳酸清除率联合心肌坏死标志物在感染性休克患者预后判断中的临床价值

摘要

目的:探讨乳酸清除率联合心肌坏死标志物在感染性休克患者预后判断中的临床价值.方法:158例感染性休克患者中126例患者6 h复苏治疗达到预期早期目标导向治疗目标.患者入院采血,测定乳酸清除率和心肌损伤标志物水平,并于治疗6 h和24 h取血检测乳酸清除率水平.分析乳酸清除率及心肌损伤标志物肌钙蛋白T(cTnT)、肌红蛋白(MYO)、肌酸激酶同工酶(CK-MB)、血浆氨基末端脑钠肽前体(NT-proBNP)的水平与感染性休克患者预后的关系.结果:乳酸清除率>10%患者病死率显著低于乳酸清除率≤10%的患者(P10%) was significantly lower than that in low lactate clearance group(lactate clearance rate≤10%)(P<0. 05). The lactate clearance rate and myocardial necrosis markers levels in the survival group were obviously lower than those in death group(P<0. 01). The difference of the value between the combination of lactate clearance rate and levels of cTnT,MYO and CK-MB and single application in judging the prognosis of patients was statistically significant(P <0. 05). The area under ROC curve of the combined detecting of myocardial necrosis markers in predicting prognosis was 0. 761(P<0. 01). The area under ROC curve and 95% CI value of the 6 h lactate clearance rate combined with myocardial necrosis markers were apparently higher than those of the single use of lactate clearance rate or myocardial necrosis markers(P < 0. 01). Conclusions:The lactate clearance rate combined with myocardial necrosis markers has important value in predicting the prognosis of the patients with septic shock,the evaluation effect of which is significantly higher than that of the single use.