APACHEⅡ评分联合红细胞分布宽度对结肠穿孔合并感染性休克患者死亡风险的预测价值  

Predictive Value of APACHEⅡScore Combined with Red Blood Cell Distribution Width in Risk of Death in Patients with Colonic Perforation Complicated with Septic Shock

作　　者：张雪[1] ZHANG Xue(Department of Emergency Department,the First Hospital Affiliated to Nanyang Med.College for Pro-fessional Training,Nanyang,Henan 473000)

机构地区：[1]南阳医学高等专科学校第一附属医院急诊科,河南南阳473000

出　　处：《中国肛肠病杂志》2024年第1期7-10,共4页Chinese Journal of Coloproctology

摘　　要：目的:探讨急性生理与慢性健康评分(APACHEⅡ)联合红细胞分布宽度对结肠穿孔合并感染性休克患者死亡风险的预测价值。方法:选取2019年6月至2022年12月收治的结肠穿孔合并感染性休克患者80例,统计患者APACHEⅡ评分与红细胞分布宽度,入院后随访2个月,根据患者2个月的预后情况分为未发生死亡组68例和发生死亡组12例。收集所有患者的临床资料,统计80例结肠穿孔合并感染性休克患者预后情况,比较2组患者的临床资料,Logistic多因素回归分析结肠穿孔合并感染性休克患者2个月死亡的危险因素,绘制受试者工作特征曲线(ROC),以曲线下面积(AUC)评价APACHEⅡ评分联合红细胞分布宽度对结肠穿孔合并感染性休克患者死亡风险的预测价值。结果:随访2个月,80例患者发生死亡12例,死亡率为15.00%(12/80),记为发生死亡组,生存68例,生存率85.00%(68/80),记为未发生死亡组。2组患者在年龄、性别、吸烟、饮酒、合并高血压、合并糖尿病、丙氨酸转氨酶(ALT)、D-二聚体(D-D)方面比较差异无统计学意义(P>0.05),发生死亡组患者APACHEⅡ评分高于未发生死亡组(P<0.05),发生死亡组红细胞分布宽度低于未发生死亡组(P<0.05)。以结肠穿孔合并感染性休克患者2个月是否死亡为因变量(否=0,是=1),以APACHEⅡ评分、红细胞分布宽度为自变量进行Logistic多因素回归分析(均为连续变量),结果显示,APACHEⅡ评分、红细胞分布宽度为结肠穿孔合并感染性休克患者2个月死亡的危险因素(P<0.05)。ROC曲线结果显示,APACHEⅡ评分与红细胞分布宽度及二者联合预测结肠穿孔合并感染性休克患者2个月死亡的AUC值(95%CI)分别为0.761(0.617~0.905)、0.695(0.523~0.867)、0.876(0.750~1.000)(P<0.05)。结论:APACHEⅡ评分与红细胞分布宽度在预测结肠穿孔合并感染性休克患者短期死亡风险中具有重要价值,且二者联合具有更高的预测价值。Objective To investigate the predictive value of acute physiological and chronic health score(APACHEⅡ)combined with red blood cell distribution width(RDW)in the risk of death in patients with colonic perforation complicated with septic shock.Methods A total of 80patients with colonic per-foration complicated with septic shock were selected from June 2019to December 2022,and the APACHEⅡscore and RDW of the patients were counted.The patients were followed up for 2months after admis-sion.According to the prognosis of the patients in the two months,total 68patients were classified as the non-death group and 12patients were classified as the death group.The clinical data of all patients were collected,and the prognosis of 80patients with colon perforation complicated with septic shock was ana-lyzed.The clinical data of the two groups were compared.The risk factors of death in patients with colon perforation complicated with septic shock within 2months were analyzed by Logistic multivariate regres-sion,and the receiver operating characteristic curve(ROC)was drawn.Area under the curve(AUC)was used to evaluate the predictive value of APACHEⅡscore and RDW in the risk of death in patients with colonic perforation complicated with septic shock.Results After 2months of follow-up,12of the 80pa-tients died,the mortality rate was 15.00%(12/80),which was recorded as the death group,and 68patients survived,the survival rate was 85.00%(68/80),which was recorded as the non-death group.There was no significant difference in age,sex,smoking,drinking,complicated by hypertension or diabetes,alanine amin-otransferase(ALT)and D-dimer(D-D)between the two groups(P>0.05).APACHE II score in the death group was higher than that in the non-death group(P<0.05).The RDW in the death group was lower than that in the non-death group(P<0.05).Whether the patients with colonic perforation com-plicated with septic shock died within 2months was the dependent variable(no=0,yes=1),and APACHEⅡscore and RDW were the independent variables for Logisti

关 键 词：结肠穿孔合并感染性休克 急性生理与慢性健康 红细胞分布宽度 死亡风险 预测价值 

分 类 号：R459.7[医药卫生—急诊医学]