APACHEII/Ⅲ与SAPSII评分系统对艾滋病合并播散性马尔尼菲青霉菌病患者病情预后评估的价值  

Comparison of APACHEⅡ/Ⅲ and SAPSⅡ in evaluating the severity and prognosis of patients with disseminated penicilliosis marneffei associated AIDS

作　　者：梁欣[1] 马卫国[1] 黎灿[1] 姚钦江[1] 黄丽静[1] 

机构地区：[1]广西钦州市第一人民医院感染性疾病科,535000

出　　处：《中国实用医药》2012年第27期12-14,共3页China Practical Medicine

基　　金：广西医药卫生自筹经费计划课题(项目编号:Z2009235);钦州市科学研究与技术开发计划项目(项目编号:20101904)

摘　　要：目的评价APACHEII/III与SAPSII评分系统用于艾滋病合并播散性马尔尼菲青霉菌病患者病情评估及预后的价值。方法对128例艾滋病合并播散性马尔尼菲青霉菌病患者分别进行APA-CHEII/III评分与SAPSII评分,比较死亡组和生存组的差异,并用ROC曲线分析比较这三个评分方法的预测能力。结果 128例患者中死亡33例(25.8%),生存95例(74.2%)。死亡组的APACHEⅡ/Ⅲ评分和SAPSⅡ评分分别是22.18±5.63、82.12±24.33和40.36±8.40,均高于生存组的14.07±5.18、53.27±11.98和34.05±6.88(P<0.01);APACHEⅡ/Ⅲ评分和SAPSⅡ评分的AUC分别为0.878、0.888和0.727,Youden指数分别是0.6434、0.6721和0.3825。APACHEⅡ/Ⅲ评分的分辨度均优于SAPSⅡ评分(P均<0.01),APACHEⅡ/Ⅲ评分的分辨度差异无显著性(P>0.05)。结论 APACHEII/III与SAPSII评分系统均能反映艾滋病合并播散性马尔尼菲青霉菌病患者的病情严重程度,但APA-CHEII/III评分系统预测预后的能力优于SAPSII评分系统。Objective To evaluate the value of acute physiology and chronic healthy condition score II/III and simple acute physiology score II （SAPSII） scoring systems to analyzing the severity and the prognosis of patients with disseminated penicilliosis marneffei associated AIDS.Methods 128 patients with disseminated penicilliosis marneffei associated AIDS were scored by APACHE II/III and SAPSⅡrespectively.The scores comparison of APACHE II/III and SAPSⅡ systems were conducted respectively between survival group and death group.The ability of APACHEII/III and SAPSⅡ systems to predict the prognosis was compared with the Receiver Operating Characteristic Curve （ROC）.Results In the 128 patients,33 died and 95 survived.The scores of APACHE II/III and SAPSⅡ in death group （22.18±5.63,82.12±24.33 and 40.36±8.40,respectively） were higher than those in survival group （14.07±5.18,53.27±11.98 and 34.05±6.88,respectively）,（P〈0.01）.The area under of ROC （AUC） of APACHE II/III and SAPSⅡ were 0.878,0.888 and 0.727,respectively,which showed significant difference between APACHE II/III and SAPSⅡ （P〈 0.01）.Their Youden’s indexes were 0.6434,0.6721 and 0.3825,respectively.Conclusion APACHE II/III and SAPSⅡ score system can evaluating the severity in patients with disseminated penicilliosis marneffei associated AIDS,but APACHE II/III were better than SAPSⅡ in predicting the prognosis.

关 键 词：SAPSⅡ评分 APACHEⅡ Ⅲ评分 ROC曲线 获得性免疫缺陷综合征 青霉属 真菌病 

分 类 号：R512.91[医药卫生—内科学]