乳酸清除率联合降钙素原清除率对脓毒症休克患者预后的回顾性研究

摘要

目的：回顾性研究乳酸清除率联合降钙素原清除率在脓毒症休克患者预后中的作用。方法：2015年1月至2015年12月中山大学孙逸仙纪念医院 ICU 收治的78例脓毒症休克患者，包括存活组54例、死亡组24例。记录患者临床特征、入ICU时液体复苏开始前的乳酸值（Lac0）和降钙素原值（PCT0）、入ICU第1个24小时内液体复苏完成后的乳酸值（Lac24）和降钙素原值（PCT24），并计算乳酸清除率和降钙素原清除率，通过受试者工作特征曲线（ROC）分析各指标的预测效度。结果：乳酸清除率组和降钙素原清除率组两者联合，在预测脓毒症休克患者28 d 全因病死率时，可以达到非常高的 AUC 值（0．911）。结论：乳酸清除率联合降钙素原清除率对脓毒症休克患者预后的预测价值最佳。%Objective: To evaluate the prognostic effect of lactate clearance rate and procalcitonin clearance rate in patients with septic shock retrospectively. Methods: 78 patients with septic shock admitted from January 2015 to December 2015 in Sun Yat-Sen Memorial Hospital, Sun Yat- Sen University. All the patients were divided into 2 groups according to the outcome: survival group and the death group. The general condition and clinical characteristics, lactate levels (Lac0)and procalcitonin levels (PCT0) on arrival in ICU, lactate levels (Lac24)and procalcitonin levels (PCT24) after fluid resuscitation during the first hour, lactate clearance rate and procalcitonin clearance rate were calculated. Results: the area under ROC curve was the largest (0.911) when ran with lactate clearance rate and procalcitonin clearance rate, suggesting its accuracy for predicting patients’ 28-day mortality. Conclusion: The lactate clearance rate combined with procalcitonin clearance rate become the best evaluation value for patients’ prognosis in our study.