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.