呼吸指数、查尔森合并症指数及SOFA在脓毒症患者病情的评估价值  

The value of respiratory index,Charlson comorbidity index and SOFA in evaluating the condition of patients with sepsis

作　　者：王小俊 梁燕 赵琰 杨钧 WANG Xiaojun;LIANG Yan;ZHAO Yan;YANG Jun(Department of Critical Care Medicine,the Third Medical Center of Chinese PLA General Hospital,Beijing 100039,China)

机构地区：[1]中国人民解放军总医院第三医学中心重症医学科,北京100039

出　　处：《热带医学杂志》2024年第10期1408-1411,共4页Journal of Tropical Medicine

基　　金：首都卫生发展科研专项项目(2011-5051-01)。

摘　　要：目的观察呼吸指数(RI)、查尔森合并症指数及脓毒症相关性器官功能衰竭评分(SOFA)在脓毒症患者中的变化,并分析三者对患者病情严重程度判断及预后评估价值。方法选取2021年12月-2023年12月中国人民解放军总医院第三医学中心收治的120例脓毒症患者为研究对象,依据中国脓毒症/脓毒性休克急诊治疗指南(2018)分为脓毒症组(n=67)和脓毒症休克组(n=53)。比较两组患者就诊时RI、查尔森合并症指数、SOFA评分及28 d预后的差异,并使用受试者工作特征(ROC)曲线评价RI、查尔森合并症指数、SOFA评分联合检测对脓毒症患者28 d死亡的诊断效能。结果脓毒症休克组RI、查尔森合并症指数、SOFA评分分别为(1.92±0.51)、(2.81±1.05)、(14.90±3.08),均高于脓毒症组(1.45±0.20)、(1.27±0.83)、(11.62±2.41),差异均有统计学意义(t=6.907、8.975、6.546,P均<0.05)。两组28 d病死率差异无统计学意义(χ^(2)=21.193,P>0.05)。ROC曲线分析显示,RI、查尔森合并症指数、SOFA评分联合检测脓毒症患者28 d死亡的曲线下面积(AUC)为0.991(95%CI:0.976~1.005),高于各指标单一预测效能。结论脓毒症患者病情严重程度与RI、查尔森合并症指数、SOFA评分存在一定的关系,且三者联合预测脓毒症患者短期预后均具有较高的价值。Objective To observe the changes in respiratory index(RI),Chalson comorbidities index,and sepsis associated organ failure score(SOFA)in patients with sepsis,and analyze their value in assessing the severity and prognosis of the patient's condition.Methods A total of 120 patients with sepsis admitted to the Third Medical Center of the General Hospital of the Chinese People's Liberation Army from December 2021 to December 2023 were selected as the research subjects.According to the Guidelines for Emergency Treatment of Sepsis/Septic Shock in China(2018),they were divided into sepsis group(n=67)and septic shock group(n=53).The differences in RI,Charlson comorbidity index,SOFA score at the time of visit and 28-day prognosis between the two groups were compared,and the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of the combined detection of RI,Charlson comorbidity index,and SOFA score for 28-day death in patients with sepsis.Results The RI,Charlson comorbidity index,and SOFA score in the septic shock group(1.92±0.51),(2.81±1.05),(14.90±3.08),respectively,which were higher than those in the sepsis group(1.45±0.20),(1.27±0.83),(11.62±2.41),and the differences were statistically significant(t=6.907,8.975,6.546;all P<0.05).There was no significant difference in 28 d mortality between the two groups(χ^(2)=21.193,P>0.05).ROC curve analysis showed that the area under the curve(AUC)of RI,Charlson comorbidity index,and SOFA score combined to detect 28-day mortality in sepsis patients was 0.991(95%CI:0.976-1.005),which was higher than the single predictive efficiency of each index.Conclusion There was a relationship between the severity of sepsis patients and RI,Charlson comorbidity index,and SOFA score;the combination of these three indexes could be used for the short-term prognosis of sepsis patients.

关 键 词：呼吸指数 查尔森合并症指数 SOFA评分 脓毒症 

分 类 号：R459.7[医药卫生—急诊医学]