简化的小儿危重病例评分法对危重型手足口病的诊断价值  

Diagnostic value of simplified pediatric critical illness score for critical hand, foot and mouth disease

作　　者：李素华[1] 陈雪夏[1] 陈益平[1] 

机构地区：[1]温州医学院附属育英儿童医院传染科,325027

出　　处：《国际流行病学传染病学杂志》2012年第6期390-392,共3页International Journal of Epidemiology and Infectious Disease

基　　金：温州市科技计划（Y20110140）

摘　　要：目的评价简化的小儿危重病例评分法在危重型手足口病中的使用价值，为临床早期识别危重症患儿以及合理救治提供参考。方法回顾性分析我院2009-2011年入住的危重型手足口病患儿35例（死亡23例），同时选取相同时期住院的重型手足口病患儿50例作为对照。患儿于入住24h内进行评分；采用ROC曲线对评分的诊断价值进行客观评价，评价金标准的主要依据：气管插管、肺出血、休克和临床死亡任一项。计算曲线下面积，并利用灵敏度、特异度和约登指数界定危重型、重型患儿的判定分值。结果ROC曲线下面积为0．94，95％CI：0.888-0．991。当评分为62时，约登指数最大（0．749），灵敏度为0．824，特异度为0．925，此时能较好地界定疾病危重程度。结论简化的小儿危重病例评分法对危重症手足口病患儿有较高的诊断价值。Objective To evaluate the simplified pediatric critical illness score （PCIS） for critical hand, foot and mouth disease（HFMD）, and provide clinical value for early identification of critically ill children, and give reference for correct treatment. Methods There were 35 critical HFMD cases （23 death cases） and 50 severe HFMD cases selected in the same period. Children were scored within 24 hours after hospitalization. Receiver operating characteristic curve（ROC） was adopted to evaluate the score criteria. The gold standard was defined according to tracheal intubation, pulmonary hemorrhage, shock or clinical death. The area under the curve was calculated. The sensitivity, specificity and Youden＇ s index were used to determine the division score on critical and severe cases. Results The area of ROC was 0.94, 95% CI：0.888-0.991. When score was 62, Youden＇s index （0.749） was the largest, the sensitivity and speci- ficity were O. 824 and 0.925 respectively. There was good value of distinguishing the critical from severe cases at this point. Conclusions PCIS has good diagnostic value for critical HFMD.

关 键 词：手足口病 危重病例评分 ROC曲线 儿童 

分 类 号：R72[医药卫生—儿科]