CPIS与APACHEⅡ评分对无创通气治疗慢性阻塞性肺疾病急性发作并呼吸衰竭的疗效预测  

The predictive value of CPIS and APACHE II for the efficacy of noninvasive ventilation therapy in patients with acute exacerbations of chronic obstructive pulmonary disease

作　　者：孔祥臣[1] 

机构地区：[1]河南省焦作煤业集团中央医院呼吸科,454150

出　　处：《中国医师进修杂志（内科版）》2008年第9期14-16,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨通过临床肺部感染评分（CPIS）和急性生理和慢性健康状况Ⅱ（APACHEⅡ）评分判断无创通气治疗慢性阻塞性肺疾病急性发作（AECOPD）并呼吸衰竭的疗效。方法对67例AECOPD并呼吸衰竭患者的临床资料进行分析，计算CPIS和APACHEⅡ评分，观察不同CPIS和APACHEⅡ评分患者的气管插管率和病死率。结果CPIS≥8分、APACHEⅡ评分≥25分的患者气管插管率、病死率较高，差异有统计学意义（P〈0．01）；两种评分其曲线下面积均在0．90以上，具有较高的分辨能力。结论可根据CPIS和APACHEⅡ评分确定AECOPD并呼吸衰竭患者选择气管插管的时机，对评估和预测预后有一定价值。Objective To evaluate the value of clinical pulmonary infection score （CPIS） and acute physiology and chronic health evaluation Ⅱ （APACHEⅡ ） in predicting the efficacy of noninvasive ventilation therapy in patients with acute exacerbations of chronic obstructive pulmonary disease（AECOPD ）. nethods The clinical data of 67 AECOPD patients with respiratory failure were analyzed with CPIS and APACHE Ⅱ were calculated respectively. The trachea cannula and death rates of patients with different CPIS and APACHE Ⅱ were observed. Results CPIS ≥8 scores and APACHE Ⅱ ≥25 scores indicated higher trachea cannula and death rates （P 〈 0.01 ）.The area under the curve was above 0.90 in both CPIS and APACHE Ⅱ . Conclusions CPIS and APACHE Ⅱ can be helpful in giving timely trachea cannula to AECOPD patients with respiratory failure. CPIS and APACHE Ⅱ play important roles in evaluation and forecasting prognosis.

关 键 词：连续气道正压通气 肺疾病 慢性阻塞性 呼吸功能不全 急性病生理学和长期健康评价 临床肺部感染评分 

分 类 号：R576[医药卫生—消化系统] R563[医药卫生—内科学]