文章摘要
达晓燕,韩 艺.乳酸及D-二聚体测定对高龄重症患者预后的评估分析[J].南京医科大学学报,2013,(11):1541~1543
乳酸及D-二聚体测定对高龄重症患者预后的评估分析
Prognosis evaluation of lactic acid and D-dimer in senile critic patients
投稿时间:2013-05-23  
DOI:10.7655/NYDXBNS20131111
中文关键词: 高龄  重症  预后  乳酸  D-二聚体
英文关键词: senile  critic  prognosis  lactic acid  D-dimer
基金项目:国家自然科学基金青年基金资助(81200196)
作者单位
达晓燕 南京医科大学附属第一医院老年ICU,江苏 南京 210029 
韩 艺 南京医科大学附属第一医院老年ICU,江苏 南京 210029 
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中文摘要:
      目的:动态观察血乳酸及D-二聚体水平对75岁以上高龄重症患者预后的评估价值。方法:分析126例75岁以上老年重症患者,分为病情改善的存活组与预后不良的死亡组,动态监测并比较患者入室1周内血乳酸及D-二聚体水平。结果:存活组55例,入室时急性生理与慢性健康状况(APACHEⅡ)评分平均(18.8 ± 4.5)分,血乳酸平均(1.7 ± 1.3)mmol/L,D-二聚体(2.03 ± 1.55)mg/L;死亡组71例,入室时APACHEⅡ评分平均(25.3 ± 6.8)分,血乳酸水平(2.4 ± 1.6)mmol/L,D-二聚体(2.36 ± 1.07)mg/L,入室时仅APACHEⅡ评分组间有显著差异;但入室1周时存活组血乳酸平均值(1.2 ± 0.6)mmol/L,D-二聚体(2.05 ± 0.81)mg/L;死亡组血乳酸平均值(5.6 ± 4.4)mmol/L,D-二聚体(3.19 ± 1.68)mg/L,均较存活组明显升高。结论:对老年重症患者动态监测血乳酸与D-二聚体水平对其预后有重要评估价值,1周内乳酸与D-二聚体水平持续下降者预后相对较好。
英文摘要:
      Objective:To evaluate the prognosis of senile critical patients over 75 years old by continuous monitoring blood lactic acid and D-dimer. Methods:One hundred and twenty-six critical patients over 75 years old were included in this research,and divided into two groups:improved surviving group and poor prognostic death group. Blood lactic acid and D-dimer were continuously monitored for the first week at admission into ICU. Results:Of 55 cases in the surviving group,APACHE II score was 18.8 ± 4.5 at admission in ICU,meanwhile lactic acid was (1.7 ± 1.3) mmol/L,and D-dimer was (2.03 ± 1.55) mg/L. Of 71 cases in the death group,APACHEⅡ score at admission was 25.3 ± 6.8,lactic acid was (2.4 ± 1.6) mmol/L,and D-dimer was (2.36 ± 1.07) mg/L. At admission,only APACHEⅡ score in the death group was significantly higher than that in the surviving group. After a week stay in ICU,lactic acid was (1.2 ± 0.6) and (5.6 ± 4.4) mmol/L,D-dimer was (2.05 ± 0.81) mg/L and (3.19 ± 1.68) mg/L in the surviving and the death group, respectively. Both indicators were significantly higher in the death group. Conclusion:Continuously monitored lactic acid and D-dimer were important indicators to evaluate the clinical prognosis of senile patients. The prognosis would usually be better if both lactic acid and D-dimer keep decreasing during the first week at admission in ICU.
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