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目的:回顾性研究乳酸清除率联合降钙素原清除率在脓毒症休克患者预后中的作用。方法:2015年1月至2015年12月中山大学孙逸仙纪念医院ICU收治的78例脓毒症休克患者,包括存活组54例、死亡组24例。记录患者临床特征、入ICU时液体复苏开始前的乳酸值(Lac_0)和降钙素原值(PCT_0)、入ICU第1个24小时内液体复苏完成后的乳酸值(Lac_(24))和降钙素原值(PCT_(24)),并计算乳酸清除率和降钙素原清除率,通过受试者工作特征曲线(ROC)分析各指标的预测效度。结果:乳酸清除率组和降钙素原清除率组两者联合,在预测脓毒症休克患者28 d全因病死率时,可以达到非常高的AUC值(0.911)。结论:乳酸清除率联合降钙素原清除率对脓毒症休克患者预后的预测价值最佳。
OBJECTIVE: To retrospectively study the role of lactic acid clearance combined with procalcitonin clearance in the prognosis of patients with septic shock. Methods: From January 2015 to December 2015, 78 patients with septic shock in ICU of Sun Yat-sen Memorial Hospital of Sun Yat-sen University were enrolled, including 54 survivors and 24 deaths. The clinical characteristics of patients were recorded. The values of lactic acid (Lac_0) and procalcitonin (PCT_0) before liquid resuscitation into ICU and the lactic acid value (Lac_ (24)) after liquid resuscitation within the first 24 hours of ICU were recorded The value of procalcitonin (PCT_ (24)) was calculated and the lactic acid clearance and procalcitonin clearance were calculated. The predictive validity of each index was analyzed by receiver operating characteristic curve (ROC). RESULTS: The combination of lactate clearance and procalcitonin clearance achieved a very high AUC (0.911) in predicting all-cause mortality at 28 days in patients with septic shock. CONCLUSION: Lactic acid clearance combined with procalcitonin clearance has the best predictive value for the prognosis of patients with septic shock.