CAJ | 학술논문

目的：评价APACHEⅡ评分和乳酸清除率对呼吸衰竭患者病情程度和预后的评估作用。方法选取50例入住我院ICU呼吸衰竭患者分为存活组和死亡组，回顾性分析进入ICU后0 h、12 h、24 h、48 h和72 h各时间点两组患者的APACHEⅡ评分和血气分析指标并作组间比较；分别将APACHEⅡ评分、A-aO2值、PaO2/FiO2值与时间点作线性回归分析，运用ROC曲线分析检测各项观察指标对呼吸衰竭患者预后的评估作用。结果死亡组患者各时间点APACHEⅡ评分和A-aO2值均高于存活组患者，差异均有统计学意义(P<0.05)；死亡组患者各时间点乳酸清除率均低于存活组患者，差异均有统计学意义(P<0.05)；进入ICU 24 h、48 h和72 h死亡组患者PaO2/FiO2值均低于存活组患者，差异均有统计学意义(P<0.05)；APACHEⅡ评分ROC曲线下面积在24 h和48 h分别为0.92和0.96；各时间点乳酸清除率ROC曲线下面积分别为0.92、0.92、0.91、0.99。结论 APACHEⅡ评分联合乳酸清除率可以作为可靠的指标评估呼吸衰竭患者病情程度和预后的指标。
목적：평개APACHEⅡ평분화유산청제솔대호흡쇠갈환자병정정도화예후적평고작용。방법선취50례입주아원ICU호흡쇠갈환자분위존활조화사망조，회고성분석진입ICU후0 h、12 h、24 h、48 h화72 h각시간점량조환자적APACHEⅡ평분화혈기분석지표병작조간비교；분별장APACHEⅡ평분、A-aO2치、PaO2/FiO2치여시간점작선성회귀분석，운용ROC곡선분석검측각항관찰지표대호흡쇠갈환자예후적평고작용。결과사망조환자각시간점APACHEⅡ평분화A-aO2치균고우존활조환자，차이균유통계학의의(P<0.05)；사망조환자각시간점유산청제솔균저우존활조환자，차이균유통계학의의(P<0.05)；진입ICU 24 h、48 h화72 h사망조환자PaO2/FiO2치균저우존활조환자，차이균유통계학의의(P<0.05)；APACHEⅡ평분ROC곡선하면적재24 h화48 h분별위0.92화0.96；각시간점유산청제솔ROC곡선하면적분별위0.92、0.92、0.91、0.99。결론 APACHEⅡ평분연합유산청제솔가이작위가고적지표평고호흡쇠갈환자병정정도화예후적지표。
Objective To evaluate the role of APACHEⅡscore combined with lactate clearance rate in the evaluation of severity and prognosis of patients with respiratory failure. Methods Fifty patients with respiratory fail-ure admitted to ICU of our hospital were divided into two groups:survival group and death group. APACHEⅡscore and blood gas analysis results of two groups of patients at the time points of entering the ICU after 0 h, 12 h, 24 h, 48 h and 72 h were retrospectively analyzed. Linear regression analysis and ROC analysis were carried out to evaluate these indicators' role on rating the prognosis of patients with respiratory failure. Results APACHEⅡscore, A-aO2 at different time points in the death group was signifiantly higher than thsoe in the survival group, and lactate clearance rate was significantly lower, all with P<0.05. PaO2/FiO2 values in the death group 24 h, 48 h and 72 h after entering in-to the ICU were significantly lower than those in the survival group (P<0.05). The area under the ROC curve (AUC) for APACHEⅡscore 24 h and 72 h after entering ICU were 0.92 and 0.96, and the area for lactate clearance rate 12 h, 24 h, 48 h and 72 h after entering ICU were 0.92, 0.92, 0.91 and 0.99, respectively. Conclusion APACHEⅡscore applied in combination with lactate clearance rate is of clinical significance for assessing the severity and prognosis of patients with respiratory failure.