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The value of serum lactic acid and its changes in prognosis assessment of patients with severe pulmonary infection |
DU Baoqing |
Department of Critical Care Medicine, Yantai Zhifu Hospital, Shandong Province, Yantai 264000, China |
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Abstract Objective To analyze the value of serum lactic acid and its changes in prognosis assessment of patients with severe pulmonary infection. Methods Clinical data of 100 cases of patients with severe pulmonary infection treated in Yantai Zhifu Hospital from February 2015 to March 2016 were analyzed retrospectively. According to the different criteria, patients were divided into different groups: ①according to the levels of blood lactate admitted in ICU, the patients were divided into hyperlactacidemia group (64 cases) and lactic acidosis group (36 cases). ②According to the value of 6 h blood lactate clearance rate, the patients were divided into high lactate clearance rate group (60 cases) and low lactate clearance rate group (40 cases). According to the prognosis, the patients were divided into survival group (79 cases) and death group (21 cases). The blood lactate levels of patients were detected, the prognosis was compared between different groups. Results Compared with lactic acidosis group, patients in hyperlactacidemia group had lower APACHEⅡ score, and higher 6 h lactate clearance rate, with statistically significant differences (P < 0.05). There were no significant differences in APACHEⅡ score and levels of blood lactate admitted in ICU between high lactate clearance rate group and low lactate clearance rate group (P > 0.05). There were no significant differences in APACHEⅡ score and levels of blood lactate admitted in ICU between survival group and death group (P > 0.05), but the 6 h blood lactate clearance rate of survival group was higher than that of control group, with statistically significant difference (P < 0.05). The mortality of hyperlactacidemia group was lower than that of lactic acidosis group, which of high lactate clearance rate group was lower than that of low lactate clearance rate group, with statistically significant differences (P < 0.05). Conclusion The level of blood lactic acid and 6 h lactic acid clearance rate can effectively reflect the severity of patients, while 6 h lactate clearance rate can also reflect the treatment effect of patients, the value in assessment is greater.
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[1] 崔惠芬,石波,尹润彬,等.血乳酸清除率与APACHEⅡ评分在感染性休克患者中的相关性探讨[J].中国医药导报,2014,11(6):26-28.
[2] 刘蓉,贾钦尧.合理行液体监测管理在保护重症肺炎患者中的应用价值[J].中国医药导报,2014,11(24):139-141.
[3] 林彬,谢谦.高容量血液滤过治疗脓毒症伴急性肺肾损伤的效果[J].中国医药导报,2015,12(22):85-88.
[4] Ioannis D,Andreas P,Johann AH,et al. Central pulmonary thrombosis secondary to severe infection of a right ventricle-to-pulmonary artery conduit [J]. Cardiol Young,2013, 23(2):265-266.
[5] 杨长春,王丹,李凯,等.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[J].中华老年多器官疾病杂志,2014,13(5):357-360.
[6] 任钰鑫,王文涛,祁绍艳,等.纤支镜联合氨溴索肺泡灌洗对脑梗死合并重症肺部感染患者炎性因子的影响[J].中国实用神经疾病杂志,2016,19(9):59-60.
[7] 王佳,张红玉.血乳酸和降钙素原与脓毒性休克的相关性研究[J].标记免疫分析与临床,2016,23(11):1257-1259,1282.
[8] 戚振云,何春来,程月光,等.血乳酸水平和乳酸清除率对煤工尘肺合并肺部感染患者预后评估的意义[J].中国继续医学教育,2016,8(9):65-66.
[9] 黄辉如.血乳酸、PCT及CRP对老年肺炎的诊断价值[J].贵州医科大学学报,2016,41(9):1104-1107.
[10] 臧金凤.血乳酸、PCT、CRP在老年肺炎中的应用价值研究[J].中外医疗,2015(24):105-107.
[11] 刘晓立,高维.临床肺部感染评分和血清CRP 在老年社区获得性肺炎预后评估中的应用价值研究[J].中国实验诊断学,2016,20(6):997-998.
[12] Cilloniz C,Torres A,Polverino E,et al. Community-acquired lung respiratory infections in HIV-infected patients:Microbial aetiology and outcome [J]. Eur Respira J,2014,43(6):1698-1708.
[13] 王浩,张勇,张培荣,等.血清降钙素原和简化临床肺部感染评分对呼吸机相关性肺炎患者预后评估的价值分析[J].临床内科杂志,2015,32(5):317-319.
[14] Kirklin JK,Naftel DC,Kormos RL,et al. Interagency Registry for Mechanically Assisted Circulatory Support(INTERMACS)analysis of pump thrombosis in the Heart Mate II left ventricular assist device [J]. J Heart Lung Transplant,2014,33(1):12-22.
[15] 胡炜科,邵利江,虞松平,等.肺部感染评分和急性生理学与慢性健康状况评分对COPD急性加重期并2型呼吸衰竭患者预后评估的应用价值[J].中国现代医生,2015,53(11):8-10,15.
[16] Thorburn K,Van-Saene H. Pulmonary bacterial co-infection in children ventilated for severe respiratory syncytial virus bronchiolitis is common [J]. Intens Care Med,2007,33(3):565.
[17] 朱琳,张浩,申国庆.血乳酸清除率和D-二聚体联合检测判断老年重症肺炎患者转归分析[J].内科,2015,10(6):799-801.
[18] 张谨超.老年心衰合并肺部感染患者监测血清降钙素原水平指导抗感染治疗的临床应用价值[D].石家庄:河北医科大学,2015.
[19] 刘汉冕,杨日焰,陈杏波,等.早期乳酸清除率、氧合指数对重症肺炎合并休克患者预后的评估作用[J].中国医药科学,2016,6(13):199-202.
[20] 悦云,余长昇.危重症患者动脉血乳酸水平及其6h清除率与APACHEⅡ的相关性及对其预后评估的临床价值[J].青海医药杂志,2014,44(11):27-29.
[21] 陈晨,吕艳琪,金志鹏,等.小儿脓毒症早期血乳酸及乳酸清除率的临床意义[J].中国医药科学,2015,5(8):59-61.
[22] 张小芳,田野,苏咸.动态监测重症肺炎患者血乳酸、中心静脉血氧饱和度及D-二聚体的临床意义[J].实用医院临床杂志,2013,10(4):80-83. |
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