CAJ | 학술논문

目的：探讨急性生理与慢性健康状况评分Ⅱ(APACHEⅡ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APACHEⅡ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APACHEⅡ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APACHEⅡ评分2~39(19.70±10.63)分，死亡组评分比存活组高(30.82±5.50vs 16.86±9.73，P＜0.001)。APACHEⅡ评分对于死亡预测的ROC曲线下面积为0.890±0.044，APACHEⅡ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 APACHEⅡ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。
목적：탐토급성생리여만성건강상황평분Ⅱ(APACHEⅡ평분)대우로력성열사병(exertional heat stroke，EHS)환자예후판단적개치。방법회고성수집10소부대의원수치로력성열사병환자54례，기중존활43례，사망11례。수집소유환자입원후24 h내각항지표적최차치근거APACHEⅡ평분량표진행평분，병운용수시자공작특정곡선(ROC곡선)분석APACHEⅡ평분대로력성열사병환자예후판단적개치。결과54례로력성열사병환자APACHEⅡ평분2~39(19.70±10.63)분，사망조평분비존활조고(30.82±5.50vs 16.86±9.73，P＜0.001)。APACHEⅡ평분대우사망예측적ROC곡선하면적위0.890±0.044，APACHEⅡ평분최가진단절점위25.5분，기민감성위90.91％、특이성위83.72％。결론 APACHEⅡ평분가이용우예측로력성열사병환자적엄중정도화예후，단개별평분교저적환자잉응인기중시。
Objective To study theAPACHEⅡscore 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 APACHEⅡscoring scale and APACHEⅡscores in predicting the prognosis of EHS patients were analyzed according totheir 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±5.50vs 16.86±9.73,P<0.001). The APECHEⅡscore was 0.890±0.044 in predicting the death of EHS patients according to the area under the ROC curve and the optimal APECHEⅡscore was 25.5 in making the diagnosis of EHS with a sensitivity of 90.91% and a specificity of 83.72%.Conclusion APECHEⅡscore can predict the severity and prognosis of EHS patients. However, attention should be paid to those with a low APECHEⅡscore.