A study of the blood hypoxia inducible factor 1α and the lactate and lactate clearance in patients with septic shock / 实用医学杂志

ABSTRACT

Objective To investigate the significance of hypoxia inducible factor lα and lactate and lactate clearance in patients with septic shock.Methods A prospective observational study was conducted.Thirty healthy volunteers (control group) and 40 cases of septic shock patients in EICU were recruited.According to the survival time,40 patients with septic shock were divided into survival group (21 cases,survival time ＞ 28 days) and death group (19 cases,survival time ≤ 28 d).The HIF-lα level was tested by ELISA assay.Lactate level of 0,6,12,24 h in arterial blood were also tested.Lactate clearance rate of the 6 h,12 h and 24 h were calculated.The association of HIF-1α and lactate level and lactate clearance rate,APACHE Ⅱ score and prognosis were evaluated.Results 40 patients with septic shock,20 male and 20 femnales,the mean age was (61.3 ± 12.8) years.The 28 day mortality rate was 47.5％.The average APACHE Ⅱ score was (23.7 ± 4.83) and arterial blood lactate levels was (5.88 ± 2.73) mmol/L.In death group and survival group,the levels of HIF-1α levels and blood lactate were significantly higher than that in the control group (P ＜ 0.05).The death group increased more significantly (P ＜ 0.05).In death group,the 6 h,12 h and 24 h lactate clearance rate were lower than the survival group (all P ＜ 0.01).APACHE Ⅱ score were higher than that in survival group (P ＜ 0.05) and the difference is statistically significant.The lactate and HIF-1α were positively correlated (r =0.868,P ＜ 0.01).Blood lactate and HIF-1α levels were all positively correlated with APACHEⅡ score (r =0.804,P ＜ 0.01) and (r =0.811,P ＜ 0.01).Conclusion The level of HIF-1α,blood lactate,lactate clearance rate are closely related with the severity and prognosis of septic shock and may become an important indicator of the prognosis.