APACHEII评分对219例重症急性肾衰竭病情程度及预后分析  

The predictive value of APACHE II score system in prognostic asse ssment for 219 patients with acute renal failure and multiple organ dysfunction syndrome

作　　者：王小兵[1] 夏业军[1] 潘怀富[2] 丁淑如[1] 

机构地区：[1]江苏省姜堰市人民医院肾内科,225500 [2]江苏省姜堰市人民医院ICU,225500

出　　处：《疑难病杂志》2005年第1期13-15,共3页Chinese Journal of Difficult and Complicated Cases

摘　　要：　目的　验证急性生理及慢性健康评分II(APACHEII)判断重症急性肾衰竭(ARF)合并多器官功能障碍综合征的病情严重程度及预后的准确性。方法　回顾性收集 219例重症ARF的A PACHEII评分,通过死亡组、存活组APACHEII评分的比较及评分与实际病死率的相关性,初步评价其评估重症ARF病情严重程度的可靠性;比较预计死亡人数与实际死亡人数,评价评分系统对预测病死率的价值。以受试者工作特性曲线(ROC)下面积表示其对个体预后的判断能力。结果　APACHEII评分死亡组比存活组高(24. 0±8. 2vs17. 6±6. 9,P<0. 001),与重症ARF的实际病死率呈正相关 (r=0. 98,P<0. 001)。实际与预计病死率比值 1. 83(P<0. 001)。APACHEII评分系统的ROC下面积为0. 774±0. 046。结论　APACHEII评分系统适用于判断重症ARF的病情严重程度及预测预后,但不能准确预测群体病死率,宜动态评分提高预测准确性。Objective To investigate the value of acute p hy siology and chronic health evaluation II (APACHE II) in evaluating the severity and predict mortality of acute renal failure(ARF) combined with mult iple organ dysfunction syndrome(MODS).Methods 219 patients with ARF and MODS were retrospectively analyzed by APACHE II.The probability of deat h was calculated for every patient according to APACHE II score.By comparing APA CHE II scores in actual motality of patients,the value of APACHE II was evaluate d.The areas under ROC of APACHE II was the value of predicting mortality of indi vidual.Results The scores in death group were higher than in life group (24.0±8.2 vs 17.6±6.9,P<0.001).The scoring value was related to the actual mortality (r=0.98,P<0.001).The areas under ROC of APACHE II was 0.774±0.046.Conclusion APACHE II score is valuable in evaluating the severity and predicting mortality, but which can not predict accu rately the severity of ARF combined with MODS.The accuracy of prediction could b e increased by dymanic scores.

关 键 词：APACHEⅡ评分 重症 ARF 病死率 病情严重程度 急性肾衰竭 ROC 表示 可靠性 验证 

分 类 号：R692.5[医药卫生—泌尿科学] R743[医药卫生—外科学]