三种评分对高危组急性肺栓塞的诊断价值  

The Diagnostic Value of Three Types of Scoring System for High Risk Subgroup of Acute Pulmonary Embolism

作　　者：齐保峰 杨瑞青[1] 冉献贵[1] QI Baofeng;YANG Ruiqing;RAN Xiangui(Fuyang Peoples Hospital,Fuyang 236000,China)

机构地区：[1]阜阳市人民医院,安徽阜阳236000

出　　处：《中外医学研究》2018年第26期19-21,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨急性肺栓塞严重指数(PESI)、修订后Geneva评分及APACHEⅡ评分对"高危组"急性肺栓塞(APE)的诊断价值及对比。方法:收集阜阳市人民医院呼吸与危重症医学科2013年6月-2017年3月诊断的43例APE病患资料,根据公布的指南标准分为高危、中危及低危三个亚组。比较三组间PESI、修订后Geneva评分及APACHEⅡ评分的差异;使用ROC曲线评价三种评分对"高危组"APE的诊断价值。结果:高危组PESI评分较中危组及低危组高(P<0.05),高危组及中危组"修订后Geneva评分"均较低危组高(P<0.01),高危组APACHEⅡ评分较中危及低危组高(P<0.05);根据ROC曲线,PESI最佳界值为97分,其对应诊断"高危组APE"的灵敏度及特异度分别为100%和73.7%;APACHⅡ评分最佳界值为10.5分,其对应诊断"高危组APE"的灵敏度及特异度分别为81.8%和68.4%;修订后Geneva评分对诊断"高危组"APE无明显价值。结论:PESI及APACHEⅡ评分对"高危组"APE具有较好的诊断价值,其中PESI评分优于APACHEⅡ评分。Objective：To explore the diagnostic value of PESI,APACHEⅡ and the revised Geneva score for high risk subgroup of acute pulmonary embolism.Method：43 consecutive subjects with APE were recruited from Fuyang Peoples Hospital from June 2013 to March 2017.According to the relevant standards,subjects were divided into high-risk subgroup,intermediate-risk subgroup and low-risk subgroup.Analyse the statistical differences of the revised Geneva score,PESI and APACHEⅡscore among three subgroups using ROC curve to evaluate the diagnostic value of three score systems for high risk subgroup of acute pulmonary embolism.Result：Compared with intermediate-risk and low-risk subgroups,high-risk APE had higher PESI（P〈0.05）.High-risk and intermediate-risk subgroups revised Geneva score were higher than low-risk subgroup（P〈0.01）.The APACHEⅡ score of high risk group of APE was higher than intermediate-risk and low-risk groups（P〈0.05）.According to ROC curve,PESI cut-off value was 97,the diagnostic sensitivity and specific degrees of high risk subgroup of APE were 100% and 73.7%.APACHEⅡ cut-off value was 10.5,the diagnostic sensitivity and specific degrees of high risk subgroup of APE were 81.8% and 68.4%.The revised Geneva score had no significant value to the diagnosis of high-risk APE.Conclusion：PESI and APACHEⅡ score have good diagnostic value for high-risk subgroups of APE,and PESI diagnostic value for high risk subgroup of acute pulmonary embolism is superior to APACHEⅡ.

关 键 词：肺栓塞 急性肺栓塞严重指数 APACHEⅡ评分 修订后Geneva评分 

分 类 号：R563.5[医药卫生—呼吸系统]