APACHEⅡ、SOFA评分及降钙素原水平对脓毒症严重度及预后的评估价值  

The Diagnostic Value of APACHEⅡ and SOFA Score and Procalcitonin for Sepsis

作　　者：顾永辉[1] 卞叶萍[1] 林兆奋[2] 

机构地区：[1]江苏省省级机关医院重症医学科,江苏南京210024 [2]第二军医大学附属长征医院急救科,上海200003

出　　处：《医学与哲学（B）》2015年第12期35-37,共3页Medicine & Philosophy(B)

摘　　要：回顾167例患者资料,根据脓毒症严重程度、感染部位及预后进行分组,比较不同组别降钙素原(PCT)水平、APACHEⅡ及SOFA评分,并利用受试者工作曲线评估其对预后的判断。结果发现脓毒症组患者的PCT水平、SOFA及APACHEⅡ评分均显著高于对照组;腹腔感染患者PCT水平显著高于肺部感染及其他部位感染;死亡组与生存组之间第一天的PCT水平无显著差异,但是第五天PCT水平在两组患者之间存在显著差异;受试者工作曲线分析显示第五天PCT水平及SOFA评分能够较好地预测脓毒症患者的预后。提示PCT水平、APACHEⅡ和SOFA评分对于脓毒症患者病情严重程度具有一定的诊断价值;PCT水平对于腹腔感染为主的患者诊断价值更好,对于预后有一定的预测价值。We retrospectively analyzed the clinical data of 167 patients, and compared the procalcitonin and APACHE Ⅱ score and SOFA score in different groups classified according to the severity of disease, site of infection and prognosis. We found there was significant difference of the proealcitonin, APACHE Ⅱ score and SOFA score in sepsis, severe sepsis and septic shock group. Procalcitonin levels in abdominal infection patients were significantly higher than other groups. No significant difference were found in the level of PCT between the first day in both death group and survival group, but PCT of the fifth day showed significant differences between two groups; ROC curve analysis showed that the fifth day PCT and SOFA scores in patients with better prognosis prediction for 28 days. In conclusion, PCT, APACHE Ⅱ and SOFA score showed good diagnostic value in patients with sepsis. PCT showed better value for diagnosis in patients with abdominal infection, and also have certain predictive value for the prognosis.

关 键 词：降钙素原 APACHEⅡ SOFA 脓毒症 

分 类 号：R631.4[医药卫生—外科学]