摘要
目的比较APACHEⅡ/Ⅲ评分和SAPSⅡ评分系统评估我国肝衰竭患者预后的临床应用价值。方法收集200例肝衰竭患者入院24h内的相关资料,计算其APACHEⅡ/Ⅲ评分和SAPSⅡ评分,比较死亡组和生存组的差异;用ROC曲线分析比较这三个评分系统的预测能力。结果死亡组的APACHEⅡ/Ⅲ评分和SAPSⅡ评分分别是(15±7)分、(65±23)分和(33±11)分,均高于生存组[(8±4)分、(42±12)分和(26±5)分,P<0.01];APACHEⅡ/Ⅲ评分和SAPSⅡ评分的AUC分别为0.795、0.827和0.683,Youden指数分别是46.61%、56.86%和33.77%。结论SAPSⅡ评分判断肝衰竭预后能力很差,APACHEⅡ/Ⅲ评分在预测肝衰竭预后方面均有肯定的临床应用价值,且APACHEⅢ评分优于APACHEⅡ评分,对肝衰竭患者的病情评估和预后预测应以APACHEⅢ评分为首选。
Objective To compare the clinical value of Acute Physiology and Chronic Health Evaluation Ⅱ/Ⅲ（APACHEⅡ/Ⅲ）system and Simple Acute Physiology Score Ⅱ（SAPSⅡ）system in predicting the prognosis of liver failure.Methods 200 cases with liver failure were scored by APACHE Ⅱ/Ⅲ and SAPSⅡ systems based on their correlated clinical data within 24 hours after their admission.The scores comparison of APACHEⅡ/Ⅲ and SAPSⅡ systems were conducted respectively between survival group and death group.The ability of APACHEⅡ/Ⅲ and SAPSⅡsystems to predict the prognosis of liver failure were compared with the Receiver Operating Characteristic Curve（ROC）.Results The APACHEⅡ/Ⅲ and SAPSⅡ scores in death group（15±7,65±23 and 33±11,respectively）were higher than those in survival group（8±4,42±12 and 26±5,respectively）,P〈0.01.The Area Under of ROC（AUC）of APACHEⅡ/Ⅲ and SAPSⅡwere 0.795,0.827 and 0.683,respectively.Their Youden＇s indexes were 46.61%,56.86% and 33.77%,respectively.Conclusions SAPSⅡsystem fails to predict the prognosis of liver failure,but APACHEⅡ/Ⅲ systems succeed in predicting the prognosis of liver failure,APACHEⅢ is better than APACHEⅡ.APACHE Ⅲ may be as the first choice in evaluating the prognosis of liver failure.
出处
《中国急救医学》
CAS
CSCD
北大核心
2008年第1期9-11,共3页
Chinese Journal of Critical Care Medicine
关键词
肝衰竭
SAPSⅡ评分
APACHEⅡ/Ⅲ评分
ROC曲线
Liver failure
Simple Acute Physiology Score Ⅱ（SAPSⅡ）
Acute Physiology and Chronic Health Evaluation Ⅱ/Ⅲ（APACHEⅡ/Ⅲ）
Receiver Operating Characteristic Curve（ROC）
