慢性阻塞性肺疾病急性加重期三重酸碱失衡与急性生理学和慢性健康状况评分Ⅲ评分及预后的关系  

Relationship among triple acid-base disturbance and acute physiology and chronic health evaluation Ⅲ score and prognosis in patients with chronic obstructive pulmonary disease acute exacerbation

作　　者：殷波[1] 惠复新[1] 赵寅滢[1] 

机构地区：[1]南京医科大学附属无锡市人民医院呼吸内科,江苏无锡214023

出　　处：《新乡医学院学报》2011年第3期346-348,共3页Journal of Xinxiang Medical University

摘　　要：目的探讨慢性阻塞性肺疾病(COPD)急性加重期三重酸碱失衡与急性生理学和慢性健康状况评分(A-PACHE)Ⅲ及预后的关系。方法选择COPD急性加重期住院患者共79例,其中符合三重酸碱失衡的36例作为观察组,同期单纯或二重酸碱失衡43例作为对照组。按照APACHEⅢ系统评分标准分别就年龄、慢性健康状况、神经学、生理学、酸碱失衡评分并预计死亡风险率。结果观察组阴离子间隙和潜在HCO3-高于对照组(P<0.01)。观察组的神经学、生理学和酸碱失衡评分及APACHEⅢ总分均高于对照组(P<0.01)。观察组和对照组死亡风险预计率分别为(17.32±12.65)%和(4.27±2.44)%,实际病死率分别为19.44%和6.98%,观察组高于对照组(P<0.01)。结论 COPD急性加重期三重酸碱失衡患者,除了APACHEⅢ酸碱失衡的分值增加外,其他生理指标评分和APACHEⅢ总分均增高,预计死亡风险发生率也增高。Objective To investigate the relationship among triple acid-base disturbance,acute physiology and chronic health evaluation（APACHE） Ⅲ score and prognosis in patients with chronic obstructive pulmonary disease（COPD） acute exacerbation.Methods Seventy-nine patients with COPD acute exacerbation were divided into two groups,thirty-six patients with triple acid-base disturbance as observation group and forty-three patients with one or double acid-base disturbance as control group.Age,chronic healthy condition,neurology,physiology and acid-base disturbance were scored and death risk rates were predicted according to the standard of APACHE Ⅲ system.Results The anions′ interspace and potential HCO3-of patients in observation group were significantly higher than those in control group（P0.01）.The neurology,physiology,acid-base disturbance and total scores of APACHE Ⅲ of patients in observation group were significantly higher than those in control group（P0.01）.The predictive death risk rate of patients in observation group was（17.32±12.65）% and that of control group was（4.27±2.44）%,while,the factual death risk rate of patients in observation group was 19.44% and control group 6.98%.Obviously,the rate of patients in observation group was higher than that in control group（P0.01）.Conclusion Besides the scores of APACHE Ⅲ are increased,other scores of physiological index,the total scores of APACHE Ⅲ and the predictive death risk rate were also increased.

关 键 词：慢性阻塞性肺疾病 三重酸碱失衡 急性生理学与慢性健康状况评分 

分 类 号：R563[医药卫生—呼吸系统]