Page 108 - 北京京煤集团总医院第十届·2022学术年会论文集

北京京煤集团总医院 第十届·2022 学术年会论文集

selected from May 2017 to May 2021. According to the occurrence of AKI, they were divided into

AKI group (n=58) and non AKI group (n=42). 58 patients with AKI were divided into survival

group (n=38) and death group (n=20) according to their 28 day survival. The differences of lactate
clearance rate and APACHE II score in each group were compared. The correlation between lactate

clearance rate and APACHE II score and patient death was analyzed by spearson correlation
analysis, and the value of separate and combined detection of lactate clearance rate and APACHE

II score in predicting AKI was analyzed. Results APACHE II score [(22.31 ± 3.10) in AKI group

was significantly higher than that in non AKI group (16.71 ± 2.87), while lactate clearance rate

[(37.31 ± 4.11)%] was lower than that in non AKI Group [(16.31 ± 2.61)%], (p<0.05);The lactate

clearance rate in the survival group [(35.14±4.98)%] was higher than that in the death group

[(17.31±5.01)%], while the APACHE II score [(18.38±3.91) points] was lower than that in the death

group [(29.31±5.14) points] (P<0.05); Spearson correlation analysis showed that APACHE II score

increased and lactate clearance rate decreased in patients with sepsis. It can be seen that APACHE

II score was significantly negatively correlated with lactate clearance rate (r=-0.412, P <0.05); The

best cut-off values of APACHE II score and lactate clearance to predict the death of AKI patients

were 19.45% and 21.87%, respectively. The AUC (95% CI) for predicting the death of AKI patients
was 0.981(0.312~1.512), which was significantly higher than that of single APACHE II score

[0.812 (0.612~0.981) and lactate clearance rate [0.769(0.412~1.329)], the difference was
statistically significant (P<0.05), and the sensitivity and specificity of the combination of the two

were 92.00% and 87.00% respectively, which were higher than that of single APACHE II score

(82.55%,84.19%) and lactate clearance (72.25%, 75.45%).Conclusion Lactate clearance rate and

APACHE II score are effective indicators to predict AKI in patients with sepsis ,their level

expression changes with the change of the disease, and the combined detection of lactate clearance

rate and APACHE II score is helpful to improve the accuracy of diagnosis and prognosis evaluation

of AKI.

【Key words】Sepsis; Acute renal injury; Lactate clearance; Acute physiology and chronic health

scoring system II ;Relevance

脓毒症是临床危重病，其发生与感染导致机体炎症反应密切相关，病死率高达 40%， 患

[1]
病率逐年递增，危及患者生命安全 。急性肾损伤（AKI）为脓毒症患者最常见并发症之一，
可增加患者死亡率，早发现、早诊断 AKI，并采取有效措施干预，是改善脓毒症患者相关肾

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