中国当代儿科杂志2016，Vol.18Issue(6)：506-510,5.DOI:10.7499/j.issn.1008-8830.2016.06.008
血乳酸在脓毒症患儿病情及预后评价中的意义
Value of blood lactic acid in evaluating disease severity and prognosis in children with sepsis
摘要
Abstract
ObjectiveTo investigate the value of blood lactic acid (BLA) in evaluating disease severity and prognosis in children with sepsis.MethodsA total of 484 children with sepsis were enrolled and divided into common sepsis group (n=310), severe sepsis group (n=105), and septic shock group (n=69). BLA level was measured before treatment, and the results of BLA re-examination after early lfuid resuscitation were collected for children with septic shock and a BLA level of >2 mmol/L.ResultsThe BLA level increased with the increasing severity of sepsis. The analysis of the receiver operating characteristic curve showed that the cut-off value of BLA for the diagnosis of septic shock was 2.25 mmol/L, with a sensitivity of 82.6% and a speciifcity of 79.8%. The fatality rates in the BLA≤1 mmol/L, BLA 1.1-2 mmol/L, BLA 2.1-4 mmol/L, and BLA >4 mmol/L groups were 8.5%, 9.4%, 27.2%, and 67.6%, respectively, and the risk of death in the BLA >4 mmol/L group was 22.4 times that in the BLA ≤1 mmol/L group. In children with septic shock who had a BLA level of >2 mmol/L before treatment and whose BLA levels were ≤2 mmol/L or >2 mmol/L after resuscitation, the fatality rates were 33.3% and 69.2%, respectively.ConclusionsBLA can be used to evaluate disease severity and prognosis in children with sepsis, and a BLA level of 2.25 mmol/L has a high value in diagnosing septic shock. Early resuscitation helps BLA level return to normal and can improve the prognosis of children with septic shock.关键词
动脉血乳酸/脓毒症/预后/儿童Key words
Arterial blood lactate/Sepsis/Prognosis/Child引用本文复制引用
颜海鹏,卢秀兰,仇君,刘萍萍,左超,祝益民..血乳酸在脓毒症患儿病情及预后评价中的意义[J].中国当代儿科杂志,2016,18(6):506-510,5.基金项目
国家十二五科技支撑计划（2012BAI04B01）南华大学研究生科研创新项目（2015XCX56）。 （）
