简化CAPS在慢性阻塞性肺疾病急性加重期伴呼吸衰竭患者中的应用价值——附90例报告  

Application of simplied CAPS in patients with AECOPD combined with respiratory failure:a report of 90 cases

作　　者：汪正光[1] 张牧城[1] 汪健蕾[1] 郑绍鹏[1] 程金霞[1] 

机构地区：[1]安徽皖南医学院附属黄山市人民医院重症医学科,245000

出　　处：《新医学》2010年第4期221-224,F0003,共5页Journal of New Medicine

摘　　要：目的:探讨简化慢性阻塞性肺疾病和支气管哮喘生理评分(CAPS)对判断慢性阻塞性肺疾病急性加重期(AECOPD)伴呼吸衰竭患者的病情和预后的价值。方法:90例AECO-PD伴呼吸衰竭患者按转归分为好转组(64例)和死亡组(24例),用CAPS及简化CAPS评估病情。其中CAPS取患者入ICU后24h内生理参数和实验室检查结果的最差值,而简化CAPS则取患者入ICU时或转ICU前的所测值。比较好转组和死亡组的CAPS、简化CAPS、有创通气时间、住ICU时间。分析CAPS及简化CAPS与病死率的关系,计算并比较两种评分法的受试者工作特征(ROC)曲线下面积。结果:好转组的CAPS、简化CAPS、有创通气时间、住ICU时间分别为(28.6±9.3)分、(22.1±8.3)分、2～15(7)d、3～19(10)d,死亡组则分别为(37.4±8.8)分、CAPS(30.9±9.3)分、6～43(20)d、7～43(21)d,两组上述指标比较差异均有统计学意义(P<0.05或0.01)。CAPS和简化CAPS均与AECOPD患者的病死率呈正相关(r分别为0.943、0.986,P均<0.01)。CAPS的ROC曲线下面积为0.788,简化CAPS的ROC曲线下面积为0.780,两者比较差异无统计学意义(P均>0.05)。结论:简化CAPS用于评估AECOPD伴呼吸衰竭患者的病情和预后是有效可行的。Objective：To explore the value of the simplied chronic obstructive pulmonary disease（COPD） and asthma physiology score（CAPS） applied in patients with acute exacerbations of COPD（AECOPD） combined with respiratory failure.Methods：Ninety cases of AECOPD were divided into survival group（n=64） and died group（n=24）,and severities of illness were evaluated by CAPS and simplied CAPS.CAPS was assessed according to patient＇s,worst physiological parameters and results of laboratory examination during their first 24 h in ICU,and simplied CAPS was calculated when patients were just admitted to ICU or before they were transferred to ICU.Several indexes of the two groups were compared,including the score of CAPS and simplied CAPS,duration of intermittent positive-pressure ventilation（IPPV）,and duration of hospitalization.The relation between the score of CAPS or simplied CAPS and fatality rate were analyzed.Area under receiver operating characteristic（ROC） curve were calcuated and compared.Results：The score of CAPS and simplied CAPS,duration of IPPV and duration of hospitalization of survival group were 28.6±9.3,22.1±8.3,2～15（7）d and 3～19（10）d,seperately.And the above mentioned indexes of died group were 37.4±8.8,30.9±9.3,6～43（20）d,and 7～43（21）d,seperately.All of them showed significant difference between the two groups（P0.05 or 0.01）.The score of CAPS or simplied CAPS and fatality rate were correlated with each other（r=0.943 or 0.986,P0.01）.The aera under the ROC curve of CAPS was 0.788,and that of simplied CAPS was 0.780,which didn＇t show significant difference.Conclusion：Simplied CAPS was feasible and effective to evaluate the severity and prognosis of patients.

关 键 词：慢性阻塞性肺疾病和支气管哮喘生理评分 慢性阻塞性肺疾病急性加重期 呼吸衰竭 疾病严重程度 

分 类 号：R563.9[医药卫生—呼吸系统] R563.8[医药卫生—内科学]