中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2010年
31期
4-7
,共4页
晏斌林%谢伦雄%赵年贵%叶惠玲%冯清洲%杜娟
晏斌林%謝倫雄%趙年貴%葉惠玲%馮清洲%杜娟
안빈림%사륜웅%조년귀%협혜령%풍청주%두연
肺炎,呼吸机相关性%急性病生理学和长期健康评价%序贯器官衰竭评估评分%多器官功能障碍综合征评分%临床肺部感染评分
肺炎,呼吸機相關性%急性病生理學和長期健康評價%序貫器官衰竭評估評分%多器官功能障礙綜閤徵評分%臨床肺部感染評分
폐염,호흡궤상관성%급성병생이학화장기건강평개%서관기관쇠갈평고평분%다기관공능장애종합정평분%림상폐부감염평분
Pneumonia,ventilator-associated%APACHE%Sequential organ failure assessment%Multiple organ dysfunction syndrome score%Clinical pulmonary infection score
目的 探讨急性生理学和慢性健康评分(APACHEⅡ)、序贯器官衰竭评估(SOFA)评分、临床肺部感染评分(CPIS)及多器官功能障碍综合征(MODS)评分对呼吸机相关性肺炎(VAP)患者的预后评估价值.方法 68例诊断为VAP患者,分别在入院第一个24 h进行APACHEⅡ、SOFA评分、MODS评分及发生VAP第一个24 h进行APACHEⅡ、SOFA评分、CPIS及MODS评分.根据实际预后分为存活组38例和死亡组30例,并根据受试者工作特征曲线下面积(AUROC)与Logistic回归分析评估四种评分系统对VAP患者预后的预测价值.结果 死亡组发生VAP第一个24 h的APACHEⅡ、CPIS、MODS评分及SOFA评分均明显高于存活组.发生VAP第一个24 h的APACHEⅡ、SOFA评分、MODS评分及CPIS AUROC分别为0.80、0.75、0.73、0.71.Logistic回归分析提示发生VAP第一个24 h的APACHEⅡ＞18分是预测VAP患者的独立相关因素(OR值为5.7,95%CI为1.9～20.0,P值为0.013).结论 发生VAP第一个24 h的APACHEⅡ评分可作为预测VAP患者预后的指标.
目的 探討急性生理學和慢性健康評分(APACHEⅡ)、序貫器官衰竭評估(SOFA)評分、臨床肺部感染評分(CPIS)及多器官功能障礙綜閤徵(MODS)評分對呼吸機相關性肺炎(VAP)患者的預後評估價值.方法 68例診斷為VAP患者,分彆在入院第一箇24 h進行APACHEⅡ、SOFA評分、MODS評分及髮生VAP第一箇24 h進行APACHEⅡ、SOFA評分、CPIS及MODS評分.根據實際預後分為存活組38例和死亡組30例,併根據受試者工作特徵麯線下麵積(AUROC)與Logistic迴歸分析評估四種評分繫統對VAP患者預後的預測價值.結果 死亡組髮生VAP第一箇24 h的APACHEⅡ、CPIS、MODS評分及SOFA評分均明顯高于存活組.髮生VAP第一箇24 h的APACHEⅡ、SOFA評分、MODS評分及CPIS AUROC分彆為0.80、0.75、0.73、0.71.Logistic迴歸分析提示髮生VAP第一箇24 h的APACHEⅡ＞18分是預測VAP患者的獨立相關因素(OR值為5.7,95%CI為1.9～20.0,P值為0.013).結論 髮生VAP第一箇24 h的APACHEⅡ評分可作為預測VAP患者預後的指標.
목적 탐토급성생이학화만성건강평분(APACHEⅡ)、서관기관쇠갈평고(SOFA)평분、림상폐부감염평분(CPIS)급다기관공능장애종합정(MODS)평분대호흡궤상관성폐염(VAP)환자적예후평고개치.방법 68례진단위VAP환자,분별재입원제일개24 h진행APACHEⅡ、SOFA평분、MODS평분급발생VAP제일개24 h진행APACHEⅡ、SOFA평분、CPIS급MODS평분.근거실제예후분위존활조38례화사망조30례,병근거수시자공작특정곡선하면적(AUROC)여Logistic회귀분석평고사충평분계통대VAP환자예후적예측개치.결과 사망조발생VAP제일개24 h적APACHEⅡ、CPIS、MODS평분급SOFA평분균명현고우존활조.발생VAP제일개24 h적APACHEⅡ、SOFA평분、MODS평분급CPIS AUROC분별위0.80、0.75、0.73、0.71.Logistic회귀분석제시발생VAP제일개24 h적APACHEⅡ＞18분시예측VAP환자적독립상관인소(OR치위5.7,95%CI위1.9～20.0,P치위0.013).결론 발생VAP제일개24 h적APACHEⅡ평분가작위예측VAP환자예후적지표.
Objective To study the significance of the prognosis assessment by acute physiology and chronic health evaluation (APACHE Ⅱ ),sequential organ failure assessment (SOFA) score,clinical pulmonary infection score(CPIS) and multiple organ dysfunction syndrome (MODS) score in the patients of ventilator-associated pneumonia (VAP). Methods The clinical data of 68 cases with VAP in the ICU or RICU were studied. APACHE Ⅱ , SOFA and MODS scores on admission and APACHE Ⅱ , SOFA, CPIS and MODS scores on the first 24-hour of VAP diagnosis were recorded. The area under the receiver operating characteristic curve(AUROC ) and Logistic regression were used to estimate the prognostic ability by the four kinds of scoring systems. Results The APACHE Ⅱ , CPIS, MODS and SOFA scores on the first 24-hour of VAP diagnosis were significantly higher in non-survivors than those in survivors. AUROC of APACHE Ⅱ ,SOFA,MODS and CPIS respectively were 0.80,0.75,0.73,0.71. Logistic regression analysis showed that only APACHE Ⅱ＞ 18 scores on the first 24-hour of VAP diagnosis was an independent predictor of the mortality (OR: 5.7,95% CI: 1.9 - 20.0, P = 0.013). Conclusion The APACHE Ⅱ on the first 24-hour of VAP diagnosis may be a useful index in predicting progress of patients with VAP.
