摘要
目的探讨血乳酸结合急性生理与慢性健康评分Ⅱ(APACHEⅡ)评分对急诊全身炎症反应综合征(SIRS)患者的预后价值。方法 126例SIRS患者根据预后情况分为存活组和死亡组。对两组患者的临床资料进行单因素分析,并记录患者入院后1 h、6 h、12 h、24 h血乳酸水平和APACHEⅡ评分,对患者血乳酸水平和APACHEⅡ评分进行Pearson相关性分析。结果两组患者入院后1 h、6 h、12 h、24 h血乳酸水平均持续下降(F分别=2.48、2.75,P均<0.05),APACHEⅡ评分亦持续明显降低(F分别=2.16、2.33,P均<0.05)。入院后24 h存活组患者的血乳酸恢复至正常水平(t=0.68,P>0.05),但死亡组患者的血乳酸水平仍明显高于正常值(t=2.09,P<0.05)。入院时、入院后1 h、6 h、12 h、24 h两组血乳酸水平、APACHEⅡ评分比较,差异均有统计学意义(t分别=2.40、2.31、2.94、2.19、2.09;2.16、1.99、2.22、2.52、2.05,P均<0.05)。Pearson相关性分析结果显示,急诊SIRS患者的血乳酸水平与APACHEⅡ评分呈明显正相关关系(r=0.37,P<0.05)。结论急诊SIRS患者的血乳酸与APACHEⅡ评分呈明显正相关关系,两者结合能够准确预测急诊SIRS患者的预后。
Objective To investigate the prognostic value of serum lactic acid combined with APACHE Ⅱ score in patients with systemic inflammatory response syndrome（SIRS）. Methods A total of 126 cases of SIRS patients were divided into survival group and the death group according to the prognosis. The clinical data of the two groups were analyzed, and the blood lactate levels and APACHE Ⅱ score of patients admitted to hospital after 1 h, 6 h, 12 h, 24 h were recorded and the relationship between serum lactate levels and APACHEⅡ scores was analyzed by Pearson correlation analysis. Results The blood lactate levels and APACHEⅡscores of two groups after admission 1h, 6h, 12 h, 24 h were declining（F=2.48,2.75, 2.16,2.33, P 0.05）. After admission 24 hours, the blood lactate level of survival group returned to normal levels（t=0.68, P〈0.05）, but the blood lactate level of death group was still significantly higher than normal（t=2.09, P〈0.05）. The blood lactate levels and APACHEⅡscores of two groups before admission and after admission 1 h, 6 h, 12 h,24 h were statistically significant（t=2.40,2.31,2.94,2.19,2.09; 2.16,1.99,2.22,2.52,2.05,P 〈0.05）. Pearson correlation analysis showed that the blood lactate levels in patients with SIRS and APACHE Ⅱ score was positive correlated（r=0.37,P〉0.05）. Conclusions Blood lactate and APACHEⅡ score showed a positive correlation. It can predict the prognosis of patients with SIRS emergency accurately through the combination of blood lactate and APACHEⅡscore.
出处
《全科医学临床与教育》
2016年第1期39-41,共3页
Clinical Education of General Practice
