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目的:通过研究急性呼吸窘迫综合征(ARDS)患者血乳酸水平的变化及其与急性生理学与慢性健康状况评分(APACHEⅡ评分)的关系,探讨血乳酸水平对ARDS病情及预后评估的价值。方法:对78例ARDS患者入住ICU 24 h内分别进行APACHEⅡ评分和血乳酸水平测定,比较不同APACHEⅡ评分分值组血乳酸水平和死亡率。结果:APACHEⅡ评分21～30分值组血乳酸水平明显高于11～20分值组(P<0.05);>30分组明显高于21～30分组(P<0.05);死亡组血乳酸水平显著高于存活组(P<0.01);死亡率与APACHEⅡ评分、血乳酸水平正相关(r=0.65,P<0.05)。结论:血乳酸水平与ARDS严重程度正相关,血乳酸水平升高预示ARDS病情的恶化,可作为ARDS严重程度临床评估的简单、定量指标。
OBJECTIVE: To investigate the value of serum lactate levels in the assessment of ARDS and its prognosis by studying the changes of blood lactic acid levels and its relationship with acute physiology and chronic health status score (APACHEⅡ) in patients with acute respiratory distress syndrome (ARDS). Methods: A total of 78 patients with ARDS were admitted to the ICU within 24 hours of APACHE Ⅱ score and blood lactate levels were measured to compare different APACHE Ⅱ scores blood lactate levels and mortality. Results: The levels of serum lactate in APACHEⅡscore 21-30 group were significantly higher than those in 11-20 group (P <0.05); the levels of serum lactic acid in group of 30% were significantly higher than those in group 21-30 (P <0.05) (P <0.01). The mortality rate was positively correlated with APACHEⅡscore and blood lactate level (r = 0.65, P <0.05). CONCLUSION: The level of blood lactate is positively correlated with the severity of ARDS. Elevated blood lactate predicts the progression of ARDS and can be used as a simple and quantitative index for the clinical evaluation of ARDS severity.