老年危重患者血乳酸水平与APACHEⅡ评分和预后的相关研究

鲍滨; 李志刚; 孙晓琳

Abstract

鲍滨,李志刚,孙晓琳.老年危重患者血乳酸水平与APACHEⅡ评分和预后的相关研究[J].Chinese journal of Epidemiology,2012,33(4):428-430

老年危重患者血乳酸水平与APACHEⅡ评分和预后的相关研究

Blood lactic acid level and APACHE II score on prognosis of critically ill elderly patients

Received:January 06, 2012

DOI：

KeyWord: 血乳酸老年患者危重症急性生理功能和慢性健康状态评分预后

English Key Word: Blood lactic acid Elderly patients Critical illness Acute physiology and chronic health evaluation Ⅱ Prognosis

FundProject:

Author Name	Affiliation	E-mail
BAO Bin	Department of Emergency, Tianjin the Forth Central Hospital, Tianjin 300140,China	baobin1101@sina.com
LI Zhi-gang	Department of Emergency, Tianjin the Forth Central Hospital, Tianjin 300140,China
SUN Xiao-lin	Department of Emergency, Tianjin the Forth Central Hospital, Tianjin 300140,China

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Abstract:

目的分析老年危重患者血乳酸水平与急性生理功能和慢性健康状态Ⅱ(APACHEⅡ)评分及预后的相关关系,为临床治疗提供指导.方法回顾性分析重症监护病房537例老年危重患者,检测人住ICU时静脉血血乳酸水平,计算24 h内APACHEⅡ评分.结果入院治疗期间死亡率为35.75％ (192/537),APACHEⅡ评分为(22.6±12.8)分,血乳酸平均值为(6.84±2.01) mmol/L.APACHEⅡ评分≤10分组的血乳酸水平和院内死亡率明显低于11≤APACHEⅡ评分≤30分和＞30分组,差异有统计学意义(P＜0.05)；11 ～ 30分组的血乳酸水平和院内死亡率明显低于＞30分组,差异有统计学意义(P＜0.05).死亡组的血乳酸水平和APACHEⅡ评分明显高于对照组,差异有统计学意义(P＜0.05).血乳酸水平与APACHEⅡ评分呈正相关(r=0.572,P＜0.05),APACHEⅡ评分与院内死亡率呈正相关(r=0.475,P＜0.05),血乳酸水平与院内死亡率呈正相关(r=0.506,P＜0.05).结论老年危重患者血乳酸水平与APACHEⅡ评分呈正相关,可作为评价危重病情的重要指标.

English Abstract:

Objective To analyze the relevance between blood lactic acid level and acutephysiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score in order to provide guideline for clinical treatment.Methods Retrospective analyses on 537 critically ill elderly patients who were hospitalized in the ICU with their blood lactic acid level tested and APACHE Ⅱ scores calculated.Results The overall death rate was 35.75％ (192/537) with the APACHE Ⅱ score as (22.6 ± 12.8),and blood lactic acid level as (6.84 ± 2.01 ) mmol/L.The blood lactic acid level among deaths was obviously higher than in the control group,with significant differences (P＜0.05).The level of blood lactic acid was positively related to APACHE Ⅱ score (r=0.572,P＜0.05) while the death rate was both positively related to APACHE Ⅱ score (r=0.475,P＜0.05) and the level of blood lactic acid (r=0.506,P＜0.05).Conclusion There seemed a positive correlation between blood lactic acid level and the APACHE Ⅱscore.Both of them showed good relevancc with thc prognosis of the disease.

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