【摘要】 目的 检测6 h乳酸清除率及降钙素原(PCT)清除率对急性呼吸窘迫综合征(ARDS)患者预后转归的影响。方法 选取2018年1月—2020年1月在本院重症医学科收治的ARDS患者126例作为研究对象，根据随访患者1年后病情转归情况的不同分为生存组73例，死亡组53例。所有患者入院后均进行急性生理与慢性健康评分II(APAHCE II评分)，采用雷度血气分析仪检测血清乳酸水平，酶联免疫吸附(ELISA)法测定血清PCT水平，计算受试者6 h乳酸清除率和6 h PCT清除率。Pearson法分析6 h乳酸清除率、6 h PCT清除率与APAHCE II评分的相关性。COX危险因素分析影响ARDS患者预后的因素。结果 与死亡组相比，生存组患者APAHCE II评分、6 h乳酸值及6 h PCT值均明显降低(P<0.05),6 h乳酸清除率、6 h PCT清除率均明显升高(P<0.05)。Pearson法分析显示，ARDS患者血清6 h乳酸清除率、6 h PCT清除率与APAHCE II评分均呈正相关(P<0.05)。COX分析显示，6 h乳酸清除率、6 h PCT清除率是ARDS患者不良预后的独立危险因素。结论6 h乳酸清除率及6 h PCT清除率与ARDS患者病情严重程度及预后情况密切相关，可能作为潜在的临床监测ARDS患者预后的标志物。更多还原

【Abstract】 Objective To investigate the effects of 6h lactate clearance rate and procalcitonin(PCT) clearance rate on the prognosis of acute respiratory distress syndrome(ARDS).Methods A total of 126 ARDS patients underwentbasic treatment, and were divided into 2 groups, survival group(n=73) and death group(n=53) after one year’s follow-up depending on the survival status. 0～24 h after hospitalization and 6 h after treatment, fasting peripheral venous blood samples were collected to test the level of serum lactate by Roche blood gas analyzer, and measure the serum PCT level by ELISA. APAHCE II score was evaluated after treatment. Pearson’s method was used to analyze the correlationsof 6 h lactate clearance and 6 h PCT clearance withAPAHCE II score. COX risk factor analysis was used to analyze the prognostic factors of ARDS.Results The APAHCE II score, 6 h lactate clearance rate and 6 h PCT value of the survival group were all significantly lower than those of the death group(all P<0.05), and the 6 h lactate clearance rate and 6 h PCT clearance rate of the survival groupwere both significantly higher than those of the death group(both P<0.05).Pearson’s analysis showed that both 6 h lactate clearance rate and 6 h PCT clearance rate were positively correlated withAPAHCE II score(both P<0.05). COX analysis showed that 6 h lactate clearance rate and 6 h PCT clearance rate were independent risk factors for adverse prognosis in ARDS.Conclusion Closely related to the severity and prognosis of ARDS,6 h lactate clearance rate and 6 h PCT clearance rate may be used as potential markersto monitor the prognosis of ARDS.更多还原