急性生理学和慢性健康状态评分与急性肺损伤评分在重症SARS患者中的应用  

Comparison between tow methods of acute physiology and chronic health evaluation Ⅲ and acute lung injury scale to evaluate the severity and prognosis of severe acute respiratory syndrome

作　　者：张国强[1] 顾承东[1] 朱宇清[1] 王丽晔 刘鹏[1] 

机构地区：[1]北京中日友好医院急诊科,100029 [2]河北省开滦唐家庄医院

出　　处：《中华流行病学杂志》2004年第9期802-804,共3页Chinese Journal of Epidemiology

摘　　要：目的 评估急性生理学和慢性健康状态评分Ⅲ(APACHEⅢ)和急性肺损伤(ALl)评分对严重急性呼吸综合征(SARS)的病情严重程度和预后的价值。方法 对38例重症SARS患者应用APACHEⅢ和ALI评分,并对结果进行比较。结果 死亡组(14例)的APACHEⅢ平均分值为74.9±22.3明显高于存活组(24例)平均分值38.3±13.2(P<0.001),APACHEⅢ各分段值与病死率呈正相关,APACHEⅢ分值≥60分,病死率明显增高(X^2=3.886,P<0.05);老年组(18例)的病死率明显高于非老年组(20例)(X^2=8.660,P<0.05);但死亡组和存活组的ALI评分分值差异无显著性(P=0.127)。结论 APACHE Ⅲ较ALI评分更能准确地判断重症SARS患者病情严重程度和预后;老年人重症SARS的病死率明显升高。Objective To evaluate the acute physiology and chronic health evaluation Ⅲ (APACHE Ⅲ) and acute lung injury (ALI) scale in the severity and prognosis of severe acute respiratory syndrome (SARS). Methods The clinical data of 38 SARS patients, including survivors (24 cases) and no survivors (14 cases) were collected and evaluated with APACHE Ⅲ and ALI scoring systems. The correlation of scores and prognosis was evaluated. Results The scores of APACHE Ⅲ in the non survivors were higher remarkably than those in the survivor group (P< 0.001 ). The scores of APACHE Ⅲ had positive correlation with the overall fatality rate. When the scores of APACHE Ⅲ was higher than 60, the mortality increased obviously (χ~2 = 3. 886, P < 0.05). Elderly patients with SARS who were over 60 years old had a high mortality (χ~2 = 8. 660, P < 0.05). The scores of ALI in the non survivors had not statistical significance than those in the survivor group (P = 0. 127). Conclusions The score of APACHE Ⅲ in the SARS are correlated with the patient's condition and prognosis. Elderly patients with SARS have a highmortality.

关 键 词：生理学 健康状态 急性肺损伤 重症SARS 严重急性呼吸综合征 病死率 APACHFⅢ 

分 类 号：R511.9[医药卫生—内科学]