乳酸和乳酸清除率对老年重症肺炎患者预后的评估

目的研究乳酸和乳酸清除率对老年重症肺炎患者预后的评估价值。方法对62例老年重症肺炎患者进行急性生理学及慢性健康状况评价Ⅱ（acute physiology and chronic health evaluationⅡ,APACHEⅡ）评分,测定入院时和治疗6h后动脉血乳酸水平,计算6h乳酸清除率,根据预后患者分成存活组和死亡组,比较其上述指标的差异。结果存活组、死亡组患者治疗前动脉血乳酸水平分别为2.2±1.5mmol/L和2.7±1.8mmol/L,（P〉0.05）;APACHEⅡ评分分别为19.4±6.9及23.9±7.1（P〈0.05）。存活组6h乳酸清除率明显高于死亡组（P〈0.01）。结论早期乳酸和乳酸清除率可用于评估老年重症肺炎患者的预后。

Lactate and lactate clearance rate on evaluation of prognosis in elderly patients with severe pneumonia

Objective To study lactate and lactate clearance rate in evaluating the prognosis of elderly patients with severe pneumonia.Methods In 62 elderly severe pneumonia patients,the scores of acute physiology and chronic health evaluationⅡ（APACHEⅡ）were evaluated.The lactate levels of arterial blood were measured before the treatment and 6 hours after the treatment.The lactate clearance rate 6h after the treatment were calculated1.The 62 elderly severe pneumonia patients were divided into the survival group and the dead group,and the group differences were analyzed.Results The arterial blood lactate levels of the survival group and the death group before the treatment were 2.2±1.5 mmol/L and 2.7±1.8 mmol/L respectively,（P〉0.05）;APACHEⅡ were 19.4±6.9 in the survival group and 23.9±7.1 in the death group respectively（P〈0.05）.At 6 hours after the treatment,the lactate clearance rate was significantly higher in the survival group than in the death group（P〈0.01）.Conclusion The early lactate and lactate clearance can be used to assess the prognosis of elderly patients with severe pneumonia.