APACHE Ⅱ评分联合全身免疫炎症指数对高龄重症肺部感染患者生存预后的预测价值  

Predictive Value of APACHE II Score Combined with Systemic Immune-Inflammatory Index for Survival Prognosis in Elderly Patients with Severe Pulmonary Infections

作　　者：周焰实 曹敏[1] ZHOU Yanshi;CAO Min(Shanghai University of Traditional Chinese Medicine Affiliated Longhua Hospital,Shanghai 200032,China)

机构地区：[1]上海中医药大学附属龙华医院,上海200032

出　　处：《转化医学杂志》2024年第3期427-430,共4页Translational Medicine Journal

基　　金：国家自然科学基金(82374397)。

摘　　要：目的 探讨急性生理和慢性健康评估系统Ⅱ(APACHEⅡ)评分联合全身免疫炎症指数(SII)对高龄重症肺部感染(SPI)患者生存预后的预测价值。方法 选取2021年1月至2023年1月上海中医药大学附属龙华医院收治的高龄SPI患者,按照1:1比例分别选择入院后28 d死亡者51例(死亡组)和存活者51例(存活组),计算APACHEⅡ评分和SII。以高龄SPI患者生存预后为因变量,建立多因素条件Logistic回归模型确定其影响因素,并绘制受试者工作特征(ROC)曲线评价APACHEⅡ评分联合SII对其的预测价值。结果 高龄SPI患者死亡的独立危险因素为脓毒症、APACHEⅡ评分增加和SII增加(P <0.05)。APACHEⅡ评分联合SII预测高龄SPI患者生存预后的曲线下面积为0.900,大于APACHEⅡ评分、SII单独预测的0.828、0.787(P <0.05)。结论 APACHEⅡ评分、SII增加为高龄SPI患者死亡的独立危险因素,APACHEⅡ评分联合SII预测高龄SPI患者生存预后的价值较高。Objective To investigate the predictive value of Acute Physiological and Chronic Health Evaluation II(APACHE II)score combined with systemic immune-inflammatory index(SII)on the survival prognosis of elderly patients with severe pulmonary infection(SPI).Methods Elderly SPI patients admitted to our hospital from January 2021 to January 2023 were selected according to a 1:1 ratio of 51 patients who died 28 d after admission(death group)and 51 patients who survived(survival group),respectively,and the APACHE II score and SII were calculated.Multifactorial conditional logistic regression was established to determine the influencing factors with survival prognosis of elderly SPI patients as the dependent variable;ROC curves were plotted to evaluate the predictive value of APACHE II score combined with SII on survival prognosis of elderly SPI patients.Results Independent risk factors for death in elderly SPI patients were sepsis,increased APACHE II score,and elevated SII(P<0.05).The area under the curve of APACHE II score combined with SII for predicting survival prognosis in elderly SPI patients was 0.900,which was greater than 0.828 and 0.787 predicted by APACHE II score and SII alone(P<0.05).Conclusion APACHE II score and elevated SII are independent risk factors for death in elderly SPI patients,and APACHE II score combined with SII has high value in predicting survival prognosis in elderly SPI patients.

关 键 词：高龄 重症肺部感染 急性生理和慢性健康评估Ⅱ 全身免疫炎症指数 生存 Logistic模型 ROC曲线 曲线下面积 

分 类 号：R563.9[医药卫生—呼吸系统]