动脉血乳酸浓度与感染性休克患者的预后关系分析

摘要

目的 研究动脉血乳酸浓度与感染性休克患者预后的关系.方法 将52例感染性休克患者根据预后不同分为存活组和死亡组,比较2组患者动脉血乳酸水平和血气分析检测结果.结果 2组患者人重症监护室(ICU)后动脉血乳酸水平均显著高于正常范围,随着治疗开始逐渐降低;存活组患者入ICU后0、6、12、24及48 h时动脉血乳酸水平均显著低于死亡组;死亡组患者入ICU后48 h时动脉血乳酸水平再次升高;存活组患者6h乳酸清除率显著高于死亡组.动脉血气分析结果显示,存活组患者的氧分压(PO2)及急性生理和慢性健康状况Ⅱ(APACHEⅡ)评分显著低于死亡组,而平均动脉压(MAP)显著高于死亡组.结论 预后不良的感染性休克患者动脉血乳酸多处于较高水平,人住ICU后6h的乳酸清除率较低的患者预后也相对更差.%Objective To study the relationship between concentration of arterial blood lactic acid (BLA) and prognosis of patients with septic shock.Methods Fifty-two patients with septic shock were divided into survival group and death group according to different prognosis.The levels of arterial BLA and results of blood gas analysis were compared in two groups.Results The levels of arterial BLA in two groups after being admitted into intensive care unit (ICU) were significantly higher than the normal range,and gradually decreased with continuation of treatment.The levels of arterial BLA in patients of survival group at 0,6,12,24 and 48 h after being admitted into ICU were distinctly lower than those in death group.The level of arterial BLA in patients of death group at 48 h after being admitted into ICU increased again.The 6-h lactate clearance of patients in survival group was remarkably higher than that in death group.The results of arterial blood gas analysis demonstrated that oxygen partial pressure (PO2) and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score in survival group were notably lower than those in death group,while the mean arterial pressure (MAP) significantly higher than that in death group.Conclusion The level of arterial BLA in patients with poor prognosis due to septic shock is usually high,and the prognosis of patients with low lactate clearance at 6 h after being admitted into ICU is relatively worse.