APACHE II及MODS评分预测ICU危重症患者预后的价值  

Comparison between Prognostic Values of Acute Physiology and Chronic Health Evaluation II and Multiple Organ Dysfunction Score on Patients in ICU

作　　者：杜昀泽[1] 何慧英[1] 崔金铃 刘学花[1] 金涛[1] 李大祥[1] 田卓民[1] 

机构地区：[1]天津市第二中心医院ICU,300120

出　　处：《天津医药》2004年第3期149-151,共3页Tianjin Medical Journal

摘　　要：目的 :比较急性生理与慢性健康状况评分Ⅱ (APACHEⅡ )与多器官功能障碍评分 (MODS)对ICU患者预后价值。方法:记录104例机械通气超过48h患者入院时的APACHEⅡ、MODS评分及住院时间与转归。结果:存活组与死亡组MODS分值差别有统计学意义(P<0.01) ,MODS评分分值越高病死率越高,APACHEⅡ评分无此趋势。用COX比例风险模型分析2组间APACHEⅡ及MODS评分差异均有统计学意义(P<0.01) ,对预后价值最大的6个器官功能障碍变量依次为 :神经系统、心血管、血液、肾脏、肝脏及呼吸系统。结论:APACHEⅡ及MODS评分对ICU患者预后均有价值 ,若评价住院期间病死率 。Objective:To compare the prognostic values of acute physiology and chronic health evaluation II(APACHE II)and multiple organ dysfunction score(MODS)on patients in ICU.Methods:The APACHE II and MODS scores,hospitalization duration and mortality were measured in 104 patients who were mechanically ventilated for >48 hours.Results:There was a significant difference of MODS between survivors and non-survivors groups(P<0.01).The mortality increased along with the elevation of MODS,but the equivalent trend for APACHE II was not found.When COX regression models were used,there was a significant difference of APACHE II and MODS between the two groups(P<0.01).Accoding to the prognostic values,the six MODS components were arranged as follows:central nervous,cardiovascular,hematologic,renal,hepatic and respiratory systems.Conclusion:Both APACHE II and MODS scores can be used to predict the outcomes of critically ill patients in ICU.The MODS may provide the additional prognostic value over the APACHE II socre when the mortality during hospitalization is analyzed.

关 键 词：APACHEⅡ MODS评分 预测 ICU 危重症 预后 多器官功能衰竭 

分 类 号：R59[医药卫生—内科学]