摘要
目的 探讨急性生理与慢性健康状况评分Ⅱ （APACHE Ⅱ评分） 对于劳力性热射病（exertional heat stroke，EHS） 患者预后判断的价值。 方法 回顾性收集10 所部队医院收治劳力性热射病患者54 例，其中存活43 例，死亡11 例。收集所有患者入院后24 h 内各项指标的最差值根据APACHE Ⅱ评分量表进行评分，并运用受试者工作特征曲线（ROC 曲线） 分析APACHE Ⅱ评分对劳力性热射病患者预后判断的价值。 结果 54 例劳力性热射病患者APACHE Ⅱ评分2 ~ 39（19.70±10.63）分，死亡组评分比存活组高（30.82±5.50 vs 16.86±9.73，P ＜ 0.001）。APACHE Ⅱ评分对于死亡预测的ROC 曲线下面积为0.890±0.044，APACHE Ⅱ评分最佳诊断截点为25.5 分，其敏感性为90.91％、特异性为83.72％。 结论 APACHE Ⅱ评分可以用于预测劳力性热射病患者的严重程度和预后，但个别评分较低的患者仍应引起重视。
Objective To study the APACHE Ⅱ score in predicting the prognosis of patients with exertional heat stroke （EHS）. Methods Fifty-four EHS patients （43 survived and 11 died） admitted to 10 Chinese PLA hospitals were included in this study. Their poorest indications within 24 h after admission were scored according to the APACHE Ⅱ scoring scale and APACHE Ⅱ scores in predicting the prognosis of EHS patients were analyzed according to their ROC curves. Results The APACHE II score was 2-39 （19.70 ± 10.63） for the 54 EHS patients. The score was significantly higher for the survived patients than for the died patients （30.82 ± 5.50 vs 16.86 ± 9.73, P 〈 0.001）. The APECHE Ⅱ score was 0.890 ± 0.044 in predicting the death of EHS patients according to the area under the ROC curve and the optimal APECHE Ⅱ score was 25.5 in making the diagnosis of EHS with a sensitivity of 90.91% and a specificity of 83.72%. Conclusion APECHE Ⅱ score can predict the severity and prognosis of EHS patients. However, attention should be paid to those with a low APECHE Ⅱ score.
出处
《解放军医学院学报》
CAS
2013年第11期1141-1143,共3页
Academic Journal of Chinese PLA Medical School
基金
国家自然科学基金项目(81050005)~~
