改良qSOFA评分对儿童脓毒症的诊断效能及分诊价值  

Diagnostic efficacy and triage value of Modified qSOFA scores for sepsis in children

作　　者：胡语航[1] 任新蕊 徐静[1] 徐雪梅 熊霞霞 HU Yuhang;REN Xinrui;XU Jing;XU Xuemei;XIONG Xiaxia(Department of Pediatric Intensive Care Unit,Sichuan Provincial Maternity and Child Health Care Hospital,Sichuan Chengdu 610041,China)

机构地区：[1]四川省妇幼保健院儿童重症医学科,四川成都610041

出　　处：《中国妇幼健康研究》2023年第4期104-108,共5页Chinese Journal of Woman and Child Health Research

基　　金：四川省妇幼保健院2019年院内科技创新基金资助项目(2019CXJJ009)。

摘　　要：目的探讨改良快速序贯器官衰竭(qSOFA)评分对儿童脓毒症的快速诊断效能,评价其对感染儿童急诊分诊的评估价值。方法选取2021年5月至2022年4月于我院急诊儿科明确诊断为感染性疾病的1197例患儿为研究对象,随机将其分为改良qSOFA组(n=601)和全身炎症反应综合征(SIRS)组(n=596),分别采用改良qSOFA及SIRS评分进行评估。采用受试者工作特征(ROC)曲线比较两种评分对儿童脓毒症的诊断效能。根据预后将明确诊断为脓毒症的102例患儿分为脏器支持组(n=18)和非脏器支持组(n=84),比较两组患儿改良qSOFA评分的差异。结果改良qSOFA及SIRS评分预测儿童脓毒症患儿的ROC曲线下面积分别为0.778、0.951,敏感度分别为52.1%和94.4%,特异性为分别为88.6%和88.0%。脓毒症患儿中,脏器支持组与非脏器支持组的改良qSOFA评分分别为2(1.75,2)、1(1,1.75)分,差异有统计学意义(Z=-3.920,P<0.05)。结论改良qSOFA评分在急诊儿科对感染患儿早期预测脓毒症的准确度欠佳;对于脓毒症患儿,改良qSOFA评分可作为病情严重程度的评估指标。Objective To investigate the efficacy of modified quick sequential organ failure assessment(qSOFA)score in the rapid diagnosis of pediatric sepsis,to evaluate the value of the modified qSOFA for emergency triage in infected children.Method A total of 1197children with a definitive diagnosis of infectious diseases in the department of pediatric emergency of our hospital from May 2021to April 2022were selected as the research objects.They were randomly divided into the modified qSOFA group(n=601)and the systemic inflammatory response syndrome(SIRS)group(n=596),which were respectively evaluated by modified qSOFA and SIRS scores.Receiver operating characteristic(ROC)curve was used to compare the diagnostic efficacy of the two scores in pediatric sepsis.According to the prognosis,102children with a definitive diagnosis of sepsis were divided into the organ support group(n=18)and non-organ support group(n=84),and the difference in modified qSOFA scores between the two groups was compared.Results The area under the ROC curve of modified qSOFA and SIRS scores for predicting pediatric sepsis was 0.778and 0.951,respectively,the sensitivity were 52.1%and 94.4%,respectively,and the specificity was 88.6%and 88.0%,respectively.In children with sepsis,the modified qSOFA scores of the organ support group and the non-organ support group were 2(1.75,2)and 1(1,1.75),and the difference was statistically significant(Z=-3.920,P<0.05).Conclusion Modified qSOFA scores perform poorly at predicting sepsis in infected children at early stages in emergency pediatrics.In children with sepsis,modified qSOFA scores can be used as an indicator of severity assessment.

关 键 词：儿童 脓毒症 快速序贯器官衰竭评分 全身炎症反应综合征评分 

分 类 号：R179[医药卫生—妇幼卫生保健]