老年重症肺部感染患者血乳酸水平的变化及与预后的关系

目的：探讨老年重症肺部感染患者血乳酸水平变化及与其预后的关系，以期为该病诊治及病情监测提供依据。方法以2011年10月至2013年5月在武警总医院住院的老年肺部感染患者76例为研究对象，随机抽取同期健康体检老年人35例为对照组，应用乳酸氧化酶法分别测定老年肺部感染组、对照组血乳酸水平。结果肺部感染组老年人血乳酸水平较对照组明显升高[（3.68±1.43） vs （1.59±0.30）mmol/L，P＜0.05]；老年肺部感染组血乳酸异常比例较对照组明显升高（85.53% vs 5.70%，P＜0.05）；根据年龄将肺部感染患者分为60～70岁年龄组和＞70岁年龄组，两者血乳酸水平比较，＞70岁年龄组明显高于60～70岁年龄组[（4.64±2.05） vs （3.06±0.87）mmol/L，P＜0.05]；根据预后将老年肺部感染患者分为死亡组和生存组，死亡组血乳酸水平明显高于生存组[（5.31±0.88） vs （3.01±1.02）mmol/L，P＜0.05]；结论老年重症肺部感染患者血乳酸水平显著升高，血乳酸水平随年龄的增长而显著升高，其程度可能与其预后相关，可作为患者病情监测及预后判断的综合指标。

Changes in serum lactic acid level in elderly patients with severe pulmonary infection and its predictive value

Objective To investigate the changes in serum lactic acid level and its relationship with prognosis in the elderly patients with severe pulmonary infection in order to provide a basis for the diagnosis, treatment and monitoring of the disease. Methods A total of 76 hospitalized elderly patients with pulmonary infection between October 2011 to May 2013 were enrolled in this study, and another 35 healthy matched individuals chosen randomly from those taking physical examination at the same time period served as normal controls. Their serum levels of lactic acid were detected by lactate oxidase method, and the results were compared and analyzed. Results The serum level of lactic acid was significantly higher in pulmonary infection group than in control group [（3.68±1.43） vs （1.59±0.30）mmol/L, P70 years old than in those between 60 to 70 years old [（4.64±2.05） vs （3.06±0.87）mmol/L, P〈0.05]. The level was also obviously higher in dead patients than in survival patients [（5.31±0.88） vs （3.01±1.02）mmol/L, P〈0.05]. Conclusion The serum level of lactic acid is significantly higher in the elderly patients with severe pulmonary infection. With the increase in the age, the serum level of lactic acid is elevated significantly, which is often associated with the disease prognosis. Serum level of lactic acid might be used as a comprehensive index of disease monitoring and prognosis in elderly patients with severe pulmonary infection.