APACHEⅡ评分、动脉血乳酸及血清降钙素原与重症肺炎预后的相关性分析

目的探讨APACHE Ⅱ评分、动脉血乳酸、血清降钙素原与重症肺炎预后之间的关系。方法分析2011--2013年住院82例重症肺炎的病例资料,统计出院时的死亡率、存活率,并根据患者存活与否将其分为存活组和死亡组,观察两组患者组间及组内APACHEII评分、动脉血乳酸、血清降钙素原的动态变化。结果出院时重症肺炎患者的存活率为59.76%,死亡率为40.24%。存活组患者确诊重症肺炎时的APACHEⅡ评分、动脉血乳酸、血清降钙素原分别为（21.85±6.50分）、（3.81±2.43 mmol/L）、（3.68±3.09 ng/mL）,而死亡组分别为（25.24±7.15分）、（5.42±3.76 mmol/L）、（5.48±4.15 ng/mL）,三者组间比较均有显著性差异（P〈0.05）;存活组患者APACHEⅡ评分、动脉血乳酸、血清降钙素原随住院天数的增加而降低,死亡组患者相反。APACHEⅡ评分与动脉血乳酸、血清降钙素原呈正相关。存活组、死亡组治疗第3、7天后三组间相比,APACHE Ⅱ评分、动脉血乳酸、血清降钙素原均具有显著性差异（P〈0.05）。结论重症肺炎治疗后的APACHEⅡ评分及动脉血乳酸、血清降钙素原的动态变化情况,可作为患者病情及预后判断的参考之一。

Correlation Analysis of APACHE II,Arterial Blood Lactate,Serum Procalcitonin and Prognosis of Se-vere Pneumonia

Objective To investigate correlation between the APACHE II score , arterial blood lactate , serum procal-citonin and prognosis of severe pneumonia.Methods The clinical data of 82 patients with severe pneumonia from 2011 to 2013 were retrospectively analyzed in our hospital.Mortality and survival at discharge were collected.We divided all the patients into two groups according to whether the patients is alive and observed the dynamic change of APACHE II score, arterial blood lactate, serum procalcitonin.Results The survival mortality of severe pneumonia patients at dis-charge were 59.76%and 40.24%.APACHE II score, arterial blood lactate, serum procalcitonin in survival group were （21.85 ±6.50 points）, （3.81 ±2.43 mmol/L）, （3.68 ±3.09 ng/mL）, and were （25.24 ±7.15 points）, （5.42 ± 3.76 mmol/L）, （5.48 ±4.15 ng/mL） in death group respectively.Significant differences （P＆lt;0.05） were found a-mong three groups of data.All data decreased with increasing days of hospitalization in survival groups while the trend was exactly the opposite in death group.APACHE II was positively correlated with arterial blood lactate and serum pro-calcitonin.There are significant differences in three groups of data between the survival group and death group on the third day as well as on the seventh day.Conclusions The dynamic change of APACHE II score , arterial blood lactate , and serum procalcitonin can be one of the references to evaluate the condition and prognosis of patients .