海南医学院学报2017，Vol.23Issue(2)：169-171,3.DOI:10.13210/j.cnki.jhmu.20161115.029
动脉血乳酸及早期乳酸清除率对 COPD 合并呼吸衰竭患者预后的评估价值
Value of arterial blood lactate and early lactate clearance in evaluating the prognosis in pa-tients with COPD merged with respiratory failure
摘要
Abstract
[ABSTRACT]Objective:To explore the value of arterial blood lactate and early lactate clearance in evaluating the prognosis in patients with COPD merged with respiratory failure.Methods:A total of 78 patients with COPD merged with respiratory failure were included in the study.The arterial blood lactate level 1d before treatment and 6 h after treatment was detected.The early lactate clearance was evaluated.The patients were divided into the severe elevation group,mild elevation group,and nor-mal control group according to the blood lactate level.APACHE Ⅱ score,28 d death rate,and other clinical related indicators in the three groups were compared.According to the early lactate clearance,the patients were divided into the high lactate clearance group and low lactate clearance group.The arterial blood lactate level,APACHE Ⅱ score,death rate,and arterial blood gas indicators in the two groups were compared.The multiple-factor analysis of prognosis was performed.Results:With the increasing of blood lactate concentration before treatment,APACHE Ⅱ score,mechanical ventilation time,ventilation rate,hospitalization time,and death rate were gradually elevated,and the comparison among the three groups was statistically significant (P <0.05).When compared with that before treatment,the arterial blood lactate level,APACHE Ⅱ score,and PaCO 2 in the high lactate clearance group were significantly reduced,but PaO 2 and pH were significantly elevated (P <0.05), while PaO 2 in the low lactate clearance group was significantly elevated (P <0.05).The death rate in the high lactate clearance group was significantly lower than that in the low lactate clearance group (P <0.05).The early lactate clearance was a factor in protecting the prognosis in patients with COPD merged with respiratory failure (P <0.05).Conclusions:The arterial blood lac-tate level and early lactate clearance can affect the prognosis in patients with COPD merged with respiratory failure.Dynamic monitoring of early blood lactate level can better evaluate the disease severity degree and prognosis.关键词
慢性阻塞性肺疾病/呼吸衰竭/动脉血乳酸/乳酸清除率/预后Key words
COPD/Respiratory failure/Arterial blood lactate/Lactate clearance/Prognosis分类
医药卫生引用本文复制引用
何敏,周浴,朱建勇,邝军,张立波,叶青..动脉血乳酸及早期乳酸清除率对 COPD 合并呼吸衰竭患者预后的评估价值[J].海南医学院学报,2017,23(2):169-171,3.基金项目
湖北医药学院科技项目(WJ2015MB220)@@@@The study was supported by the Scientific and Technological Project of Hubei University of Medicine with the number of WJ 2015MB220 （WJ2015MB220）
