目的：探讨APACHE Ⅱ评分、血清乳酸水平及6h乳酸清除率在脓毒症患者预后评估中的价值。方法回顾性分析68例脓毒症患者，发生脓毒症后血清乳酸水平及6h血乳酸清除率及24h内急性生理学与慢性健康状况评分（APACHE Ⅱ评分），比较不同APACHE Ⅱ评分组血清乳酸水平及6h乳酸清除率。结果 APACHEⅡ分值>20分组血清乳酸水平明显高于10~20分组及<10分组（P<0.05）；10~20分组血清乳酸水平高于<10分组（P<0.05）。APACHEⅡ分值>20分组6h乳酸清除率明显低于10~20分组及<10分组（P<0.05）。APACHEⅡ分值10~20组6h乳酸清除率低于<10分组（P<0.05）。血清乳酸水平与APACHEⅡ评分显著正相关（r=0.654，P<0.01），6h乳酸清除率与APACHEⅡ评分显著负相关（r=-0.38，P<0.05）。死亡组血清乳酸水平明显高于存活组（P<0.01），死亡组24h乳酸清除率明显低于存活组（P<0.05）。结论随着APACHE Ⅱ评分增高，血清乳酸水平也相应增高，而6h乳酸清除率下降；血清乳酸水平及6h乳酸清除率与严脓毒症患者病情严重程度相关，可作为脓毒症患者病情以及预后评估的参考指标。%ObjectiveTo explore the APACHEⅡ score,serum lactate levels and 6 hour lactic acid clearance rate in the assessment of prognosis of patients with sepsis in the value.MethodsA retrospective observation of 68 patients admitted to the ICU ward patients with sepsis, serum lactate levels occurred after sepsis and 6 hour blood lactate clearance rate and 24 hours of urgent sexual physiology and chronic health evaluation (APACHEⅡ score),comparison of different APACHEⅡ score group and the serum lactic acid level and 6 hours of lactic acid clearance rate. Resultsthe level of serum lactate APACHEⅡ score of 20 points or more group was significantly higher than that in APACHE 10-20 group and APACHEⅡ score II score below 10 points group(P<0.05). APACHEⅡ score in group 10-20 serum lactic acid level was higher than APACHEⅡscore below 10 points group(P<0.05). APACHEⅡ score of 20 points or more in 6 hours lactate clearance rate was significantly lower than that of 10-20 group and APACHE APACHEⅡ score II score below 10 points group(P<0.05). APACHEⅡ score in group 10-20 6 hour lactic acid clearance rate is lower than the APACHEⅡ score below 10 points group(P<0.05). Significant positive correlation serum lactic acid level and APACHEⅡscore(r=0.654,P<0.01),6 hour lactic acid clearance rate and APACHEⅡ scores were significantly negative correlation(r=-0.38,P<0.05). The death of serum lactic acid level group was significantly higher than that in the survival group(P<0.01),death 24 hours lactate clearance rate was significantly lower than that in the survival group(P<0.05).ConclusionsWith the APACHE increasing II score,serum lactate levels will increase accordingly,while the 6 hour lactic acid clearance decreased;serum lactic acid level and 6 hour lactic acid clearance rate and the disease severity in patients with severe sepsis related,reference can be used as indicators of disease in the patients with sepsis and prognosis evaluation.
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