Changes of serum procalcitonin, lactate and lactic acid clearance in severe pneumonia and its clinical significance
10.3760/cma.j.issn.1008-6706.2018.04.012
- VernacularTitle:重症肺炎患者血清降钙素原、乳酸水平和乳酸清除率的变化及临床意义
- Author:
Jiwei CHEN
1
Author Information
1. 325804,浙江省苍南县第三人民医院重症医学科
- Keywords:
Pneumonia;
Shenfu injection;
Inflammation mediators;
Lactic acid
- From:
Chinese Journal of Primary Medicine and Pharmacy
2018;25(4):453-456
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the changes of serum procalcitonin ( PCT ) , lactate and lactic acid clearance in severe pneumonia and its clinical significance .Methods Seventy patients with severe pneumonia were enrolled,including 16 cases with hospitalized pneumonia and 54 cases with community acquired pneumonia .All patients were exsanguinated early morning venous blood on day 1,4,7 after treatment,and transferred-out or before death.PCT and arterial lactic acid were measured and 24 -hour lactate clearance was calculated .According to the outcome , the patients were divided into survival group and death group .At different time points , the PCT and Lac levels were observed in the two groups .The patients were divided into high lactic acid clearance group and low lactic acid clearance group according to the 24h lactic acid clearance rate .The initial Lac and mortality were observed . Results All patients had 25 cases of deaths and 45 cases of survive.There were no statistically significant differences in PCT and Lac levels at the 1st day of treatment between the two groups (F=0.87,P=0.19;F=0.03,P=0.40). The PCT levels[(19.5 ±11.1)ng/L,(7.9 ±3.2)ng/L,(3.6 ±1.4)ng/L]and Lac values[(2.8 ±1.6)mmol/L, (2.2 ±1.1)mmol/L,(1.7 ±0.8)mmol/L]at the 4th,7th day of treatment and transferred -out in the survival group were significantly lower than those in the death group [PCT:(39.6 ±24.8) ng/L,(40.4 ±21.9) ng/L,(41.6 ± 38.3)ng/L,Lac:(6.8 ±3.2)mmol/L,(6.2 ±2.1)mmol/L,(7.7 ±2.8)mmol/L,F=3.84,P=0.003;F=7.38, P=0.00;F=4.95,P=0.00;F=5.86,P=0.00;F=6.05,P=0.00;F=10.48,P=0.00].In death group,the serum PCT value and lactic acid value were not significantly decreased with the treatment , and remained in the higher state at the 4th,7th day of treatment and before death ,and even higher than the first day of treatment .The mortality of the high lactic acid clearance group was 15.79％,which was significantly lower than 59.38％ in the low lactic acid clearance group (χ2 =14.37,P=0.00).The initial Lac and PCT of the two groups had no statistically significant differences ( t =0.17, P =0.43;t =0.41, P =0.34 ).Conclusion For the patients with severe pneumonia ,the detection of serum PCT and lactic acid levels and dynamic observation is helpful to judge the severity of the disease.The early lactic acid clearance rate may be of positive significance to the prognosis of patients .
