危重病患者临床预后与APACHEⅡ评分及血乳酸关系的研究

目的 分析急诊重症监护室(emergency intensive care unit, EICU)危重病患者临床预后与APACHEⅡ评分、血乳酸关系。方法 收集同济大学附属同济医院急诊科2014年8月至2015年6月收治的EICU危重病患者70例,根据临床预后分为两组,即治愈组及未治愈组。两组患者分别记录性别、年龄、诊断及预后,进行血乳酸检测及APACHEⅡ评分的比较,并分析患者临床预后与APACHE Ⅱ评分及血乳酸值的相关性。结果 治愈组患者血乳酸水平及APACHEⅡ评分均明显低于未治愈组患者,差异具有统计学意义(P<0.05)；危重症患者的临床预后与APACHE Ⅱ评分呈负相关(r=-0.284,P=0.019),与血乳酸值亦呈负相关(r=-0.279,P=0.021)。结论 危重病患者APACHEⅡ评分及血乳酸水平越低,其临床预后越好。APACHEⅡ评分及血乳酸是判断危重病患者病情严重程度及预后的良好指标。
ObjectiveTo investigate the correlation of APACHEⅡ score and blood lactate levels with clinical outcomes of critically ill patients in emergency intensive care unit (EICU). MethodsSeventy critically ill patients admitted in EICU from August 2014 to June 2015 were enrolled, among whom 56 cases survived and 14 cases died. Sex, age, diagnosis and prognosis were documented, blood lactate levels were tested and APACHEⅡ scores were assessed in two groups. The correlation between clinical outcomes and APACHE Ⅱ score, blood lactate level was analyzed. Result The APACHEⅡ scores and blood lactate levels in survival group were lower than those in non-survival group (P<0.05). APACHEⅡ scores and blood lactate levels were negatively correlated with clinical outcomes in critically ill patients(r=-0.284,P=0.019; r=-0.279,P=0.021, respectively). Conclusion Lower APACHE Ⅱ score and blood lactate levels are associated with favorable clinical outcomes in critically ill patients, indicating that APACHEⅡscore and blood lactate levels might be useful biomarkers for prediction of the severity and prognosis in critically ill patients