【摘要】 目的分析动态检测血乳酸及D-二聚体水平在预测老年重症肺炎患者转归中的应用价值。方法选取老年重症肺炎患者94例作为研究对象,根据患者的转归分为存活组(63例)和死亡组(31例),比较分析两组患者的动脉血乳酸、6 h内乳酸清除率及D-二聚体水平的变化、疾病评估预后系统(APACHEⅡ)评分。结果存活组患者血乳酸水平在入院治疗12~24 h后迅速降低到正常水平,而死亡组患者血乳酸呈持续高水平状态;死亡组患者D-二聚体水平治疗72 h内无明显下降,明显高于存活组(P<0.05);APACHEⅡ评分与血乳酸浓度呈正相关(r=0.656,P<0.05)。结论动态监测老年重症肺炎患者的血乳酸及D-二聚体水平,可以评估疗效,判断预后,具有重要的临床应用价值。更多还原

【Abstract】 Objective To investigate the prediction value of blood lactic acid combined with D-dimer on clinical outcomes in elderly patients with severe pneumonia. Methods A total of 94 cases of elderly patients with severe pneumonia were divided into survival group( 63 cases) and mortality group( 31 cases) according to clinical outcomes,the arterial blood lactate,lactate clearance rate within 6 h and D-dimer,prior disease prognosis assessment system( APACHEⅡ) score between the two groups were compared. Results After 12- 24 hours of treatment,the level of blood lactic acid in survival group was decreased to the normal level,but it was keeping the high level in the mortality group; the level of D-dimer in mortality group had no obvious changes after treatment for 72 h,which was significantly higher than that of survival group( P < 0. 05); there was a positive correlation between blood lactic acid and APACHEⅡ scores( r = 0. 656,P < 0. 05). Conclusions Dynamic monitor of blood lactic acid and D-dimer is benificial for the evaluation of efficacy and prognosis of severe pneumonia in elderly patients and has important clinical values.更多还原