ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2016, Vol. 8 ›› Issue (6): 631-635.doi: 10.3969/j.issn.1674-3865.2016.06.027

• 临床研究 • 上一篇    下一篇

脓毒症患儿血乳酸、降钙素原水平与预后的相关性分析

黄雪萍   

  1. 546100 广西 来宾，来宾市人民医院儿科
  • 出版日期:2016-12-25 发布日期:2018-11-19
  • 作者简介:黄雪萍(1980-)，女，主治医师。研究方向：小儿内科疾病的诊治，E-mail：zxd0081@126.com

Analysis of the correlation between the level blood lactate and procalcitonin and prognosis in children with sepsis

HUANG Xueping   

  1. Department of Pediatrics, Laibin People 's Hospital, Laibin 546100，China
  • Online:2016-12-25 Published:2018-11-19

PDF (PC)

136

摘要： 目的：探讨血乳酸、降钙素原水平与脓毒症患儿预后的关系，旨在降低脓毒症患儿病死率。
方法：2013年3月至2016年2月来宾市人民医院儿科收治住院的脓毒症患儿53例。根据预后情况，将其分为生存组38例和死亡组15例，比较两组患儿血乳酸及降钙素原水平；根据入院时血乳酸水平，将53例脓毒症患儿分为低乳酸水平组(<2.0 mmol/L)27例，中乳酸水平组(2.0～3.9 mmol/L)17例、高乳酸水平组(≥4.0 mmol/L)9例，比较3组患儿生存及死亡率；根据降钙素原水平，将53例脓毒症患儿分为正常组(<0.05 μg/L)15例，轻度升高组(0.05～2.0 μg/L)15例，中度升高组(2.1～10 μg/L)8例，重度升高组(>10 μg/L)15例，比较4组患儿生存及死亡率；同时比较两种指标不同水平预测死亡的ROC曲线结果。
结果：生存组血乳酸及降钙素原水平显著低于死亡组，差异有统计学意义(P<0.05)。血乳酸水平达中等水平后，死亡率明显增加，与生存率相当，差异无统计学意义(P>0.05)；降钙素原水平达到中重度升高水平时，死亡率增加显著，与生存率比较差异有统计学意义(P<0.05)。血乳酸水平≥2.0 mmol/L(尤其是≥4.0 mmol/L)以及降钙素原>2.0 μg/L(尤其是>10 μg/L)时，脓毒症病死率预测性更准确。
结论：血乳酸及降钙素原水平与脓毒症患儿预后密切相关，尤其是二者的联合检测更有助于脓毒症病情判断与预后评估。

关键词: 脓毒症, 血乳酸, 降钙素原, 预后, 儿童

Abstract: Objective:To investigate the relationship between the levels of blood lactate and procalcitonin and the prognosis of sepsis in children in order to reduce the mortality of sepsis.
Methods:From March 2013 to February 2016, 53 patients with sepsis were admitted to Pediatric Department of Laibin People 's Hospital. According to the prognosis, the patients were divided into survival group(38 cases) and death group(15 cases). The levels of blood lactate and procalcitonin were compared between the two groups. According to the blood lactate level, the 53 cases of sepsis were divided into 3 groups, 27 cases(<2.0 mmol/L) in low lactic acid group(A), 17 cases in the medium lactic acid group(2.0~3.9 mmol/L)(B) and 9 cases in the high lactic acid group(≥4.0 mmol/L)(C). The survival and death rate of the three groups(0.05~2.0 μg/L) were compared. According to the level of procalcitonin, these patients were divided into 4 groups:5 cases(<0.05 μg/L) in normal group(D),15 cases(0.05~2.0 μg/L) in slight increase group(E),8 cases(2.1~10 μg/L) in moderate increase group(F) and 15 cases(>10 μg/L) in significant increase group(G).The survival rate and mortality of the four groups were compared. The ROC curves in predicting death were compared(P<0.01).
Results:The levels of blood lactate and procalcitonin in the survival group were significantly lower than those in the death group(P<0.05). When the lactate level was moderately increased,the mortality increased significantly, similar to the survival rate, and there was no statistal difference(P>0.05).When the level of procalcitonin increased to a moderate or significant level, the mortality increased significantly, and the survival rate was significantly higher than that of the survival rate(P<0.05), the difference being statistically significant(P<0.05). The prediction of sepsis mortality was more accurate when blood lactate levels were ≥2.0 mmol/L(especially≥4.0 mmol/L) and procalcitonin>2.0 μg/L(especially>10 μg/L).
Conclusion：The levels of blood lactate and procalcitonin are closely related to the prognosis of sepsis, and the combined detection of serum lactic acid and procalcitonin may be more helpful to evaluate the situation and prognosis of sepsis.

Key words: Sepsis, Blood lactate, Procalcitonin, Prognosis, Children