中华危重病急救医学
中華危重病急救醫學
중화위중병급구의학
Chinese Critical Care Medicine
2013年
4期
211-214
,共4页
刁孟元%王涛%崔云亮%林兆奋
刁孟元%王濤%崔雲亮%林兆奮
조맹원%왕도%최운량%림조강
乳酸%剩余碱%脓毒症%预后
乳痠%剩餘堿%膿毒癥%預後
유산%잉여감%농독증%예후
Lactate%Base excess%Sepsis%Prognosis
目的 探讨早期联合检测动脉血乳酸与剩余碱(BE)对脓毒症患者预后的评估价值.方法 回顾性分析2009年7月至2012年12月入住本院重症监护病房(ICU)脓毒症患者的临床资料,按照预后分为存活组和死亡组,比较两组患者入院时动脉血乳酸及BE的差异,观察动脉血乳酸、BE及两者联合判断预后的受试者工作特征曲线(ROC曲线)下面积(AUC),并寻找出动脉血乳酸及BE预测脓毒症预后的最佳截断值.结果 共纳入118例脓毒症患者,其中存活组75例,死亡组43例.存活组和死亡组入院动脉血乳酸[mmol/L:1.20(0.90)和2.30(1.90)]及BE(mmol/L:0.44±5.13和-4.35±4.86)比较差异均有统计学意义(均P=0.000).动脉血乳酸、BE及两者联合预测脓毒症的AUC分别为0.805、0.755及0.822.在动脉血乳酸＞1.7 mmol/L及BE＜-3 mmol/L时,具有较高的敏感度(79.1％和69.8％)及阳性似然比(3.955和2.493).结论 入院时动脉血乳酸联合BE检测可以较好地预测脓毒症患者的预后.
目的 探討早期聯閤檢測動脈血乳痠與剩餘堿(BE)對膿毒癥患者預後的評估價值.方法 迴顧性分析2009年7月至2012年12月入住本院重癥鑑護病房(ICU)膿毒癥患者的臨床資料,按照預後分為存活組和死亡組,比較兩組患者入院時動脈血乳痠及BE的差異,觀察動脈血乳痠、BE及兩者聯閤判斷預後的受試者工作特徵麯線(ROC麯線)下麵積(AUC),併尋找齣動脈血乳痠及BE預測膿毒癥預後的最佳截斷值.結果 共納入118例膿毒癥患者,其中存活組75例,死亡組43例.存活組和死亡組入院動脈血乳痠[mmol/L:1.20(0.90)和2.30(1.90)]及BE(mmol/L:0.44±5.13和-4.35±4.86)比較差異均有統計學意義(均P=0.000).動脈血乳痠、BE及兩者聯閤預測膿毒癥的AUC分彆為0.805、0.755及0.822.在動脈血乳痠＞1.7 mmol/L及BE＜-3 mmol/L時,具有較高的敏感度(79.1％和69.8％)及暘性似然比(3.955和2.493).結論 入院時動脈血乳痠聯閤BE檢測可以較好地預測膿毒癥患者的預後.
목적 탐토조기연합검측동맥혈유산여잉여감(BE)대농독증환자예후적평고개치.방법 회고성분석2009년7월지2012년12월입주본원중증감호병방(ICU)농독증환자적림상자료,안조예후분위존활조화사망조,비교량조환자입원시동맥혈유산급BE적차이,관찰동맥혈유산、BE급량자연합판단예후적수시자공작특정곡선(ROC곡선)하면적(AUC),병심조출동맥혈유산급BE예측농독증예후적최가절단치.결과 공납입118례농독증환자,기중존활조75례,사망조43례.존활조화사망조입원동맥혈유산[mmol/L:1.20(0.90)화2.30(1.90)]급BE(mmol/L:0.44±5.13화-4.35±4.86)비교차이균유통계학의의(균P=0.000).동맥혈유산、BE급량자연합예측농독증적AUC분별위0.805、0.755급0.822.재동맥혈유산＞1.7 mmol/L급BE＜-3 mmol/L시,구유교고적민감도(79.1％화69.8％)급양성사연비(3.955화2.493).결론 입원시동맥혈유산연합BE검측가이교호지예측농독증환자적예후.
Objective To study the prognostic value of arterial lactate combined with base excess (BE) in sepsis patients.Methods Clinical data of patients admitted to intensive care unit (ICU) from July 2009 to December 2012 were retrospectively analyzed.Patients were divided into survivor group and non-survivor group,and the arterial blood lactate and BE concentrations were compared between groups.The receiver operating characteristic curve (ROC curve) was drawn and area under the ROC curve (AUC) was calculated to analyze the function of arterial lactate,BE and their combination in judging the prognosis of sepsis.The best cut-off values of arterial lactate and BE for sepsis prognosis were searched.Results One hundred and eighteen patients were enrolled with 75 in survivor group and 43 in non-survivor group.There were significant differences in arterial lactate [mmol/L:1.20 (0.90),2.30 (1.90)] and BE (mmol/L:0.44 ± 5.13,-4.35 ± 4.86) between two groups (both P=0.000).The AUC for mortality prediction was 0.805,0.755 and 0.822 for arterial blood lactate,BE,and their combination respectively.Using arterial lactate higher than 1.7 mmol/L and BE lower than-3 mmol/L as cut-off values,a better sensitivity (79.1％ and 69.8％) and positive predictive value (3.955 and 2.493) can be obtained.Conclusion Combination of arterial lactate and BE can be a better indicator of prognosis in sepsis patients.
