动脉血乳酸清除率与急性生理及慢性健康评分在感染性休克治疗中的预测价值

目的回顾性研究动脉血乳酸清除率与急性生理及慢性健康（APACHEⅡ）评分在感染性休克治疗中的预测价值。j芎法采集人住ICU的62例感染性休克患者治疗前动脉血乳酸，进行急性生理和慢性健康状况（APACHEⅡ）评分，计算24h动脉血乳酸清除率，并根据28d病程转归分为存活组和死亡组，比较两组间动脉血乳酸、24h动脉血乳酸清除率和APACHEⅡ的差异。结果动脉血乳酸水平存活组明显低于死亡组水平，差异有统计学意义（P〈0．01）；死亡组患者A—PACHEⅡ评分明显高于存活组，而24h动脉血乳酸清除率明显低于存活组，差异均有统计学意义（P〈0．01）。结论24h动脉血乳酸清除率结合APACHEⅡ评分系统进行综合判断可作为感染性休克评价疗效和预后的指标。

The prediction value of arterial blood lactate clearance rate and acute physiology and chronic health score in the treat-nent of septic struck

Objective A retrospective study of arterial blood lactate clearance rate and acute physiology and chronic health score （APACHE Ⅱ ） in the treatment of septic shock in the prediction value. Methods Acquisition in ICU 62 patients with septic shock patients before treatment of arterial blood lactic acid, acute physiology and chronic health conditions （A- PACHE Ⅱ ） score, calculated 24 hours arterial blood lactate clearance rate, divided into two groups of survival group and death group according to the course of 28d outcome, compared the arterial blood lactic acid, 24 hours arterial blood lactate clearance rate and APACHE Ⅱ. Results In ICU arterial blood lactate level of survival group was significantly lower than that of the death group, differences were statistically significant （P〈0.01） ; APACHE Ⅱ score of death group was significantly higher than survival group, whereas 24 hours arterial lactate clearance rate was significantly lower in the survival group, the difference was statistically significant （P〈0.01）. Conclusion 24 hours arterial lactate clearance rate and APACHE Ⅱ score system for com- prehenslive judgement can be used as septic shock to evaluate the efficacy and prognosis.