内科

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。

ObjectiveTo investigate the prediction value of blood lactic acid combined with D-dimer on clinical outcomes in elderly patients with severe pneumonia. MethodsA 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. ResultsAfter 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 72h ,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). ConclusionsDynamic 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.

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