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中国临床研究英文版:2024,37(11):1691-1694
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血乳酸清除率对连续肾脏替代疗法治疗的脓毒症患者预后的影响
(1. 武汉大学人民医院医疗部,湖北 武汉 430060;2. 武汉大学人民医院重症医学科,湖北 武汉 430060)
Effect of blood lactate clearance rate on the prognosis of sepsis patients undergoing continuous renal replacement therapy
摘要
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Received:September 11, 2023   Published Online:November 20, 2024
中文摘要: 目的 通过分析不同临床结局的接受CRRT治疗的脓毒症患者的血乳酸水平以及血乳酸清除率,探讨血乳酸水平和血乳酸清除率对此类患者预后的影响。方法 回顾性分析2019年1月至 2022年11月在武汉大学人民医院接受CRRT治疗的60例脓毒症患者的临床资料,根据出院存活情况分为存活组和死亡组,比较两组患者治疗后动脉血乳酸水平和乳酸清除率。结果 60例患者中存活45例(75.00%),死亡15例(25.00%)。与存活组相比,死亡组年龄大,住院时间长,APACHEⅡ评分和SOFA评分高(P<0.05);死亡组呼吸频率高,CRRT治疗时间长,入院血乳酸水平、CRP水平、中性粒百分比高(P<0.05);死亡组治疗后0 h和24 h的血乳酸水平高,治疗后24 h和48 h的血乳酸清除率降低,差异有统计学意义(P<0.05)。结论 CRRT是治疗脓毒症的有效方法,48 h血乳酸清除率对CRRT治疗的脓毒症患者预后的判断具有应用价值。
Abstract:Objective To analyze the blood lactate levels and lactate clearance rate in septic patients undergoing continuous renal replacement therapy (CRRT) with different clinical outcomes, and to explore the value of blood lactate levels and lactate clearance rate on the prognosis of such patients. b>Methods A retrospective analysis was conducted on the clinical data of 60 septic patients who received CRRT treatment at Renmin Hospital of Wuhan University from January 2019 to November 2022. Based on discharge survival status, patients were divided into the survival group and the death group. Arterial blood lactate levels and lactate clearance rates were compared after treatment between the two groups. Results Of the 60 patients, 45 survived (75.00%), and 15 died (25.00%). Compared with the survival group, the death group had older age, longer hospital stay, and higher APACHEⅡ and SOFA scores (P<0.05); the death group had a higher respiratory rate, longer CRRT treatment time, and higher admission blood lactate levels, CRP levels, and neutrophil percentage (P<0.05); the blood lactate levels in the death group were higher at 0 and 24 hours after treatment, and the blood lactate clearance rate decreased at 24 and 48 hours after treatment, with statistical significance (P<0.05). Conclusion CRRT is an effective treatment for sepsis. The 48-hour lactate clearance rate has significant prognostic value for septic patients undergoing CRRT.
文章编号:     中图分类号:R631    文献标志码:A
基金项目:湖北陈孝平科技发展基金会临床研究基金资助项目(CXPJJHI12000005-07-02)
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