APACHEⅢ评分及氧合指数与老年重症肺炎预后的相关性分析  

Analysis of the Correlation of APACHE Ⅲ Score and Oxygenation Index with the Prognosis of Elderly Patients with Severe Pneumonia

作　　者：姜敏敏[1] 徐晓雯[2] 韩志青[2] 张含之[2] 雷撼[3] 

机构地区：[1]同济大学医学院,上海200092 [2]上海市杨浦区中心医院呼吸科,上海200090 [3]同济大学附属东方医院呼吸科,上海200120

出　　处：《现代生物医学进展》2013年第4期662-665,共4页Progress in Modern Biomedicine

基　　金：上海市杨浦区中心医院科研课题计划项目(20080222)

摘　　要：目的:探讨氧合指数、APACHEⅢ评分与老年重症肺炎患者预后之间的关系。方法:回顾性分析我院呼吸科住院治疗的78例老年重症肺炎患者的病例资料,统计出院时的死亡率、存活率,并根据患者存活与否将其分为存活组和死亡组,观察两组患者组间及组内APACHEⅢ评分、氧合指数的动态变化。结果:出院时老年重症肺炎患者存活率为58.97%,死亡率为41.03%。存活组患者确诊重症肺炎时的APACHEⅢ评分、氧合指数分别为(37.69±19.67)、(279.01±26.68),而死亡组分别为(68.43±26.54)、(256.12±29.66),二者均具有显著性差异(P<0.05);死亡组、存活组患者治疗后3、5、7天后两组间相比,APACHEⅢ评分、氧合指数均具有显著性差异(P<0.05);死亡组、存活组患者治疗后5、7天与入院时相比,APACHEⅢ评分、氧合指数均具有显著性差异(P<0.05),治疗后第7天与第3天相比,APACHEⅢ评分、氧合指数均亦具有显著性差异(P<0.05)。存活组患者APACHEⅢ评分随住院天数的增加而降低,氧合指数随住院天数的增加而升高;死亡组患者相反。APACHEⅢ评分与氧合指数呈负相关。结论:老年重症肺炎患者治疗后氧合指数、APACHEⅢ的动态变化情况,可作为患者病情及预后判断的参考之一。Objective： To investigate the correlation of oxygenation index and APACHE Ⅲ score with the prognosis of elderly patients with severe pneumonia.Methods： The clinical data of 78 patients with severe pneumonia was retrospectively analyzed.The patients were divided into the survival group and non-survival group according to the survival condition when they were discharged.The oxygenation index and APACHE Ⅲ score of two groups were observed before and after treatment.Results： The survival rate was 58.97%,while the mortality rate was 41.03%.The APACHE Ⅲ score and oxygenation index on admission were 37.69± 19.67 and 279.01 ±26.68 in the survival group,while they were 68.43± 26.54 and 256.12 ±29.66 in the non-survival group,it showed significant differences（P0.05）.The APACHE Ⅲ scores and oxygenation indexes in 3,5,7 days after treatment in the survival group were significantly different from those in the non-survival group（P0.05）.The APACHE Ⅲ scores and oxygenation indexes in 5,7 days after treatment in both groups were respectively significantly higher and lower than those on admission,which were significantly higher and lower on the 7th day after treatment than those on the 3rd day after treatment.The APACHE Ⅲ score decreased with the increase of hospital stay in the survival group,the oxygenation index was contrary to the trend of APACHE Ⅲ score.The APACHE Ⅲ score was negatively correlated with the oxygenation index.Conclusion： The dynamic changes of APACHE Ⅲ score and oxygenation index in the patients with severe pneumonia after treatment could be used as a reference for the status and prognosis judgment of this disease.

关 键 词：APACHEⅢ评分 氧合指数 老年患者 重症肺炎 预后 

分 类 号：R563.1[医药卫生—呼吸系统]