3种评分对慢性阻塞性肺疾病急性加重患者预后评估价值  

Evaluation of the three scores to assess the severity of chronic obstructive pulmonary disease exacerbation

作　　者：徐苗苗[1] 于树云[1] 张亭亭 

机构地区：[1]天津医科大学第二医院呼吸科,天津300211

出　　处：《天津医科大学学报》2017年第6期530-533,共4页Journal of Tianjin Medical University

摘　　要：目的:探讨BAP-65、CURB-65、DECAF 3种评分量表对慢性阻塞性肺疾病急性加重(AECOPD)住院患者预后的应用价值。方法:回顾性分析302例慢性阻塞性肺疾病急性加重患者的临床资料,在入院24 h内分别进行了CURB-65评分、BAP-65评分及DECAF评分。根据存活情况分为死亡组与生存组,比较死亡组与生存组各量表评分,对各自评分进行分组,计算各组死亡率,构建ROC曲线分析3种评分对AECOPD患者院内死亡率的预测。结果:死亡组与生存组在3种评分分值之间存在显著性差异(P<0.05)。随着3种评分分值的增加,患者院内死亡率相应增加;DECAF评分及CURB-65评分在4分以上,院内死亡率分别为48%,50%。BAP-65评分在4分以上院内死亡率为80%。在预测院内死亡率上,CURB-65评分和BAP-65评分曲线下面积在0.80以上,DECAF评分曲线下面积为0.95。各评分量表AUROC面积分别两两进行Z检验,结果提示CURB-65评分与BAP-65评分比较,差异无统计学意义(P>0.05),DECAF评分分别与CURB-65评分和BAP-65评分比较,差异有统计学意义(P<0.05)。结论:入院时进行CURB-65、BAP-65及DECAF 3种评分对于预测AECOPD患者院内死亡率均有一定价值,DECAF评分在3个评分中对患者预后预测准确度最高。O bjective： To explore the value of the CURB-65 score,the BAP-65 score,the DECAF score evaluating the prognosis with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）. Methods： The CURB-65 score, BAP-65 score, DECAF score of302 cases patients were analyzed within 24 hours after admission. According to survive conditions, the 302 patient were divided into death and survival group. Then the difference of these three scores were compared between the two groups. Each scale was grouped by their own scores, and the mortality was calculated respectively. The prediction value of the scores on hospital mortality was evaluated through ROC curve. Results： The death group and the survival group had significant differences among the three scores（P〈0.05）.There were apparent differences among the three scores of CURB-65, BAP-65,DECAF, and the difference between each group had statistical significance（P〈0.05）.With the increase of three rating scores, hospital mortality increased correspondingly. In the patients whose DECAF and CURB-65 scores were higher than four points, the hospital mortality 48%, 50%, and BAP-65 scores was higher than four points, and the hospital mortality was 80%.The area under the receiver operating characteristic curve（AUROC） of CURB-65 and BAP-65 was above 0.80, the AUROC of DECAF was 0.95. By Z test, the results showed that there was no statistically significant difference（P〉0.05） between CURB-65 score and BAP-65 score. DECAF score was compared with CURB-65 and BAP-65 score, respectively, and the difference was statistically significant（ P〈0.05）. Conclusion： CURB-65, BAP-65 and DECAF scores on admission may have certain value in predicting hospital mortality rate of AECOPD. The degree of DECAF score has the highest accuracy among the three scores.

关 键 词：慢性阻塞性肺疾病 急性加重 CURB-65评分 BAP-65评分 DECAF评分 

分 类 号：R563[医药卫生—呼吸系统]