SOFA评分对重型肝炎合并MODS的预后评价  

Sequential organ failure assessment score in the evaluation of the prognosis of severe hepatitis with multiple organ dysfunction syndrome

作　　者：高洪波[1] 许敏[1] 胡肖兵[1] 李粤平[1] 童裕维[1] 

机构地区：[1]广州市第八人民医院重症肝病区,广东广州510060

出　　处：《现代医药卫生》2005年第10期1185-1186,共2页Journal of Modern Medicine & Health

摘　　要：目的:探讨序贯器官衰竭估计(SOFA)评分与重型肝炎(以下简称重肝)合并多器官功能障碍综合征(MODS)患者预后的关系。方法:应用SOFA评分体系对重肝合并多器官功能障碍综合征进行回顾性统计分析,比较存活组与死亡组患者入院时SOFA评分、最大SOFA评分、ΔSOFA评分的差异,评价SOFA评分在预后估计中的作用。结果:重肝合并MOF病死率89.2% ,随器官衰竭个数的增加,病死率急剧增加,重肝合并MODS的累计最大SOFA评分、累计ΔSOFA评分存活组与死亡组相比差异有显著性(P<0.01) ,入院时累计SOFA评分差异无显著性。各单个器官系统相比,存活组与死亡组最大SOFA评分和ΔSOFA评分中循环、肾、神经系统差异有显著性(P<0.01) ,呼吸、凝血系统差异无显著性;而入院时各单个器官SOFA评分差异仍无显著性。结论:重肝合并MOF病死率高。Objective:To investigate the sequential organ failure assessment(SOFA)score in predicting the prognosis of patient with multiple organ dysfunction syndrome(MODS)secondary to the severe hepatitis.Methods:A retrospective analysis was made in37patients with MODS secondary to the severe hepatitis in the department of severe hepatitis.The SOFA scoring system was used to compare the differences between admission SOFA scores,ΔSOFA scores and maximum SOFA scores in survivors and non-survivors.Results:The mortality rate of severe hepatitis with MOF is89.2%,With the number of failing organs increased,the mortality rate in creased.In severe hepatitis with multiple organ dysfunction syndrome,the cumulative maximumSOFA scores and cumulativeΔSOFA scores in nonsurvivors were significantly higher than those of survivors(P<0.01).There was no significant difference between two groups for cumulative admission SOFA scores.In regard to organs,the death group exˉhibited higher in cardiovascular,renal and neurologic systems SOFA scores than in the survival group(P<0.01),but not for coagulation and respiratory systems.However,the admission SOFA scores did not showdifference between survivors and nonsurvivors for each organ.Conclusion:The mortality rate of severe hepatitis with MOF is high.The cumulative maximum SOFA score andΔSOFA score can be used to predict the progˉnosis in severe hepatitis with MODS.

关 键 词：SOFA评分 MODS 重型肝炎 序贯器官衰竭估计(SOFA) 多器官功能障碍综合征 预后评价 回顾性统计分析 显著性 入院时 死亡组 存活组 病死率 评分体系 预后估计 器官系统 神经系统 凝血系统 评价作用 MOF 患者 相比 

分 类 号：R59[医药卫生—内科学] R512.6[医药卫生—临床医学]