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目的：探讨血清酮体比值（ＡＫＢＲ）对判断感染性多脏器功能失常综合征病情轻重程度和预后的意义。方法：测定正常对照组、肝硬化组、急性感染组（又分Ａ、Ｂ、Ｃ３组）患者乙酰乙酸（ＡｃＡｃ）、β羟丁酸（３ＨＢ）及ＡＫＢＲ等指标水平。结果：肝硬化组ＡｃＡｃ〔（０．４２±０．１５）ｍｍｏｌ／Ｌ〕和３ＨＢ〔（０．８２±０．１８）ｍｍｏｌ／Ｌ〕明显低于正常对照组〔（０．９９±０．２０）ｍｍｏｌ／Ｌ和（１．４０±０．２５）ｍｍｏｌ／Ｌ〕，Ｐ均＜０．０１；急性感染Ａ、Ｂ、Ｃ３组的ＰａＯ２、乳酸、阴离子间隙具有显著性差异（Ｐ均＜０．０１）；ＡＫＢＲ与ＡＰＡＣＨＥⅢ评分呈明显负相关（ｒ＝－０．８１２，Ｐ＜０．００１）；血清酮体水平与ＡＰＡＣＨＥⅢ评分间无明显直线相关关系（ｒ＝０．１６３，Ｐ＞０．０５）；ＡＫＢＲ和ＰａＯ２与ＡＰＡＣＨＥⅢ评分间有明显相关性（ｒ＝０．７２２，Ｐ＜０．０１）。结论：ＡＫＢＲ能更早期、直接、准确地反映肝细胞线粒体的受损程度和能量代谢状态，可以作为评估感染性ＭＯＤＳ病情严重程度及预后的重要指标。
Objective: To investigate the significance of serum Ketone ratio (AKBR) in judging the severity and prognosis of infectious multiple organ dysfunction syndrome. Methods: The levels of AcAc, 3HB and AKBR in normal control group, cirrhosis group and acute infection group (divided into groups A, B and C3) were also measured. Results: AcAc 〔(0.42 ± 0.15) mmol / L〕 and 3HB 〔(0.82 ± 0.18) mmol / L〕 in liver cirrhosis group were significantly lower than those in normal control group 〔(0.99 ± 0. 20) mmol / L and (1.40 ± 0.25) mmol / L〕, all P <0.01. There was significant difference in PaO2, lactate and anion gap between A, B and C3 groups (P < 0.01). There was a significant negative correlation between AKBR and APACHEⅢ score (r = -0.812, P <0.001). There was no significant linear correlation between serum ketone level and APACHE Ⅲ score (r = 0.163, P> 0.05). There was a significant correlation between AKBR and PaO2 and APACHE Ⅲ scores (r = 0.722, P <0.01). Conclusion: AKBR can reflect mitochondrial damage and energy metabolism state earlier and more directly and accurately, which can be used as an important index to assess the severity and prognosis of infectious MODS.