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目的探讨危重病患者动脉血乳酸水平与急性生理学及慢性健康状况评分Ⅱ(A-PACHEⅡ),以及预后的相关性。方法 2011年6月至2012年6月,解放军159医院诊治的60例危重病患者,根据临床预后情况将其分为死亡组和存活组,每组30例,对两组患者入院24 h内的APACHEⅡ评分、动脉血乳酸水平进行监测和比较。结果 60例危重病患者的A-PACHEⅡ评分均高于10分。与18例A-PACHEⅡ评分11～20分患者相比,28例A-PACHEⅡ评分21～30分患者的动脉血乳酸水平明显升高(P<0.05);与28例A-PACHEⅡ评分21～30分患者相比,14例A-PACHEⅡ评分>30分患者的动脉血乳酸水平明显升高(P<0.05)。与存活组相比,死亡组的A-PACHEⅡ评分、动脉血乳酸水平明显升高(P<0.05)。结论对于危重病患者,动脉血乳酸水平与APACHEⅡ评分呈正相关性增长,也是病情变化的重要监测指标。
Objective To investigate the correlation between arterial blood lactate levels and acute physiology and chronic health status score Ⅱ (A-PACHEⅡ) in critically ill patients and their prognosis. Methods From June 2011 to June 2012, 60 critically ill patients diagnosed and treated by People’s Liberation Army 159 Hospital were divided into death group and survival group according to the clinical prognosis, 30 cases in each group. The patients in two groups were admitted within 24 hours APACHE Ⅱ score, arterial blood lactate levels were monitored and compared. Results The A-PACHEⅡscores of 60 critically ill patients were higher than 10 points. Compared with 18 patients with A-PACHEⅡ score of 11-20, arterial blood lactic acid level was significantly increased in 28 patients with A-PACHEⅡscore 21-30 (P <0.05), and 28 patients with A-PACHEⅡscore 21-30 Arterial blood lactate levels were significantly higher in 14 patients with A-PACHEⅡ score> 30 (P <0.05). Compared with the survival group, the A-PACHE II score and arterial blood lactate level in the death group were significantly increased (P <0.05). Conclusion For critically ill patients, arterial blood lactate levels and APACHE Ⅱ score was positively correlated with growth, but also an important indicator of disease changes.