血乳酸在老年重症肺部感染患者的变化及与预后的关系.DOC

·临床研究· 血乳酸在老年重症肺部感染患者的变化及与预后的关系 杨长春1，王 丹1，李 凯1，杨贵荣2，高 敏3，赵海滨4，孙振学1* （武警总医院：1南楼一科，2重症医学科，3感染控制科，4检验科，北京 100039） 【摘 要】目的 探讨老年重症肺部感染患者血乳酸水平变化及与其预后的关系，以期为该病诊治及病情监测提供依据。方法 以2011年10月至2013年5月在武警总医院住院的老年肺部感染患者76例为研究对象，随机抽取同期健康体检老年人35例为对照组，应用乳酸氧化酶法分别测定肺部感染组、对照组血乳酸水平。结果 肺部感染组较对照组老年人血乳酸水平较对照组明显升高[（3.68±1.43） vs （1.59±0.30）mmol/L，P＜0.05 ]；老年肺部感染组血乳酸异常比例较对照组明显升高（85.53% vs 5.70%，P＜0.05）；根据年龄将肺部感染患者分为60～70岁年龄组和＞70岁年龄组，两者血乳酸水平比较，＞70岁年龄组明显高于60～70岁年龄组[（4.64±2.05） vs （3.06±0.87）mmol/L，P＜0.05]；根据预后将老年肺部感染患者分为死亡组和生存组，死亡组血乳酸水平明显高于生存组[（5.31±0.88） vs （3.01±1.02）mmol/L，P＜0.05]；结论 老年重症肺部感染患者血乳酸水平显著升高，血乳酸水平随年龄的增长而显著升高，其程度可能与其预后相关，可作为患者病情监测及预后判断的综合指标。 【关键词】老年人；重症肺部感染；血乳酸；预后 【中图分类号】 R592；R563.1 【文献标识码】 A 【DOI】 ? Changes and predictive value of serum lactic acid level in elderly patients with severe pulmonary infection YANG Chang-Chun1, WANG Dan1, LI Kai1, YANG Gui-Rong2, GAO Min3, ZHAO Hai-Bin4, SUN Zhen-Xue1* (1First Department of South Building, 2Department of Critical Care Medicine, 3Department of Infection Control. 4Department of Clinical Laboratory, General Hospital of Chinese People’s Armed Police Forces, Beijing 100039, China) 【Abstract】 Objective To investigate the changes of serum lactic acid level and its relationship with prognosis in the elderly patients with severe pulmonary infection in order to provide a basis for the diagnosis, treatment and monitoring of the disease. Methods A total of 76 hospitalized elderly patients with pulmonary infection between October 2011 to May 2013 were enrolled in this study, and another 35 healthy matched individuals chosen randomly from those taking physical examination served as normal control at the same time period. Their serum levels of lactic acid were detected by lactate oxidase method, and the results were compared and analyzed. Results The serum level of lactic acid was significantly higher in pulmonary infection group than in control group (3.68±1.43 vs 1.59±0.30 mmol/L, P＜0.05). The percentage of the ederlyl with