血乳酸水平对急性呼吸窘迫综合征的预后评估价值

摘要

Objective: Analyzing the relationship between the changes of levels of blood lactic acidosis of patients with acute respiratory distress syndrome (ARDS) and acute physiology and chronic health evaluation score (APACHE II score) in order to explore the value of blood lactate levels in the assessment of ARDS condition as well as the prognosis. Method: APACHE II score and blood lactate levels were tested in 78 patients with ARDS admitted to ICU within 24 h and the APACHE II scores,blood lactate levels and mortality were compared. Results: The blood lactate level in APACHE II scores of 21~30 group was significantly higher than that in APACHE II scores of 11~20 (P < 0.05),and the blood lactate level in APACHE II scores of above 30 group was significantly higher than that in APACHE II scores of 21~30(P < 0.05). The blood lactate levels in death group was significantly higher than that in the survival group (P < 0.01).The mortality had a positive correlation with the APACHE II scores and blood lactate levels(r = 0.65,P < 0.05). Conclusion: Blood lactate level is positively correlated with the severity of ARDS. An increasing blood lactate level may indicate a progression of ARDS. Blood lactate level can be used as a simple quantitative indicator of the clinical assessment of the severity of ARDS.%　　目的：通过研究急性呼吸窘迫综合征(ARDS)患者血乳酸水平的变化及其与急性生理学与慢性健康状况评分(APACHE II评分)的关系,探讨血乳酸水平对ARDS病情及预后评估的价值.方法：对78例ARDS患者入住ICU 24 h内分别进行APACHEⅡ评分和血乳酸水平测定,比较不同APACHE II评分分值组血乳酸水平和死亡率.结果：APACHE II评分21~30分值组血乳酸水平明显高于11~20分值组(P <0.05)；>30分组明显高于21~30分组(P <0.05)；死亡组血乳酸水平显著高于存活组(P<0.01)；死亡率与APACHE II评分、血乳酸水平正相关(r =0.65,P <0.05).结论：血乳酸水平与ARDS严重程度正相关,血乳酸水平升高预示ARDS病情的恶化,可作为ARDS严重程度临床评估的简单、定量指标.