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目的:探讨血乳酸清除率与重症肺炎预后的关系。方法:根据重症肺炎入院28d死亡率分为存活组及死亡组,测定两组入院后48h动态血乳酸变化情况。并根据48h乳酸清除率的高低将患者分为两组,比较两组间预后情况。结果:共收集2011年10月~2014年6月期间于无锡市人民医院ICU住院的重症肺炎患者30例,死亡组12例,存活组18例。重症肺炎患者入院6h血乳酸清除率死亡组(7.3±6.9)%,存活组(13.5±7.5)%,死亡组明显低于存活组,差异有统计学意义(P<0.01),24h血乳酸清除率死亡组(6.87±3.89)%,存活组(26.5±8.4)%,死亡组明显低于存活组,差异有统计学意义(P<0.05),24h血乳酸清除率死亡组(8.8±10.9)%,存活组(18.88±9.24)%,死亡组明显低于存活组,差异有统计学意义(P<0.05),48h血乳酸清除率死亡组(14.6±12.9)%,存活组(47.8±12.1)%,死亡组明显低于存活组,差异有统计学意义(P<0.05)。48h乳酸清除率较低组15人死亡12人,较高组15人死亡0人,两组差异有统计学意义(P<0.05)。结论:入院48h内乳酸清除率对判断重症肺炎预后具有较高的价值。
Objective: To investigate the relationship between the serum lactic acid clearance and the prognosis of severe pneumonia. Methods: According to the 28-day mortality rate of severe pneumonia admitted to hospital, the patients were divided into survival group and death group. The dynamic changes of blood lactic acid at 48 hours after admission were measured. The patients were divided into two groups according to the lactic acid clearance rate at 48 hours, and the prognosis was compared between the two groups. Results: A total of 30 patients with severe pneumonia hospitalized in ICU of Wuxi People’s Hospital from October 2011 to June 2014 were collected, including 12 deaths and 18 survivors. Serum lactate clearance rate of patients with severe pneumonia was (7.3 ± 6.9)% at 6 h after admission, and (13.5 ± 7.5)% in survivors group, and death group was significantly lower than that of surviving group (P <0.01) (6.87 ± 3.89)% in survival group and (26.5 ± 8.4)% in survival group, the death group was significantly lower than that in survival group (P <0.05) %, Survival group (18.88 ± 9.24)%, death group was significantly lower than survival group, the difference was statistically significant (P <0.05), 48h blood lactic acid clearance rate of death group (14.6 ± 12.9)%, survival group (47.8 ± 12.1 )%, The death group was significantly lower than the survival group, the difference was statistically significant (P <0.05). There were 15 deaths in 12 lactic acid clearance group and 12 deaths in 15 lactic acid group. There were 15 deaths and 0 deaths in the higher group. There was significant difference between the two groups (P <0.05). Conclusion: The rate of lactic acid clearance within 48 hours after admission is of high value in judging the prognosis of severe pneumonia.