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乳酸清除率评估急性重度乙醇中毒患者预后的临床研究

魏绍震,卢绍禹   

  1. 天津市第四医院
  • 收稿日期:2012-06-15 修回日期:2012-07-11 出版日期:2013-01-15 发布日期:2013-01-15
  • 通讯作者: 魏绍震

A Clinical Study on the Lactate Clearance Rate Assessing Prognosis of Patients with Acute Severe Alcoholic Intoxication

  • Received:2012-06-15 Revised:2012-07-11 Published:2013-01-15 Online:2013-01-15

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摘要：

【摘要】 目的探讨乳酸清除率与急性重度乙醇中毒患者预后的关系。方法 80例入ICU即刻动脉血乳酸值高于2.0mmol/L的急性重度乙醇中毒患者,入ICU6h后再次测定动脉血乳酸值,计算乳酸清除率。记录入ICU后的APACHEⅡ评分、病死率。80例分成存活组(76例)、死亡组(4例)以及高乳酸清除率组(68例)、低乳酸清除率组(12例)。分析乳酸清除率与预后的关系。结果各组APACHEⅡ评分和初始动脉血乳酸值比较差异均无统计学意义(均P>0.05)。存活组乳酸清除率显著高于死亡组{[17.55%(14.08%,19.68%)]vs[(7.95%(-1.05%,8.70%)]},(P<0.01)。高乳酸清除率组病死率显著低于低乳酸清除率组(1.5%vs25.0%,P<0.01)。结论乳酸清除率可用于早期评估急性重度乙醇中毒患者的预后。 

关键词: 急性乙醇中毒, 乳酸清除率, 预后

Abstract: Objective The present study attempts to investigate the correlation between the prognosis and the lactate clearance rate in patients with acute severe alcoholic intoxication. Methods Eighty patients suffering from acute severe alcoholic intoxication with initial serum lactate levels after admission to ICU greater than 2.0 mmol/L underwent detection of serum lactate six hours later to calculate the lactate clearance. The APACHE II score and mortality were recorded. The eighty patients fell under survival group (n=76) and death group (n=4), or high lactate clearance rate group (n=68) and low lactate clearance rate group (n=12). The correlation of lactate clearance rate with prognosis was analyzed. Results After the experiment no significant differences in APACHE II score and the initial blood concentration of lactate were found (P＞0.05）. The lactate clearance rate of the survival group was (17.24±8.08)%, which was significantly higher than that of the death group [(0.85±4.45)%, P ＜0.01]. The mortality of the high lactate clearance rate group was 1.47%, which was significantly lower than that of the low lactate clearance rate group (25%, P ＜0.001). Conclusion The lactate clearance rate can be used for early evaluation of the prognosis of the patient with acute severe alcoholic intoxication.

Key words: Acute alcoholic intoxication, Lactate clearance rate, Prognosis