摘要
目的比较不同预后急性脑卒中合并发多器官功能障碍综合征患者APACHEⅢ、MODS、SOFA、LODS评分,对其临床特点和致死危险因素进行分析,为降低该疾病致死率提供依据。方法回顾性分析2011年12月—2013年9月ICU收治的134例急性脑卒中合并多器官功能障碍患者病例。根据预后分为死亡组和存活组,采用急性生理学与慢性健康状况评分系统Ⅲ(APACHEⅢ)、多脏器功能不全评分(MODS)、序贯性器官衰竭评分(SOFA)评分标准、Logistic脏器功能不全评分(LODS评分)对2组患者进行评分。并采用Logistic回归分析对APACHEⅢ评分、MODS评分、SOFA评分、LODS评分、血糖水平、C反应蛋白水平、基础疾病积分进行多因素分析,评估预后相关危险因素。结果生存组患者年龄、APACHEⅢ评分、MODS评分、SOFA评分、LODS评分均显著性低于死亡组(P<0.05)。Logistic回归分析结果:血糖>7.8 mmol/L、C反应蛋白、基础疾病评分、APACHEⅢ评分、MODS评分、LODS评分、SOFA评分是影响患者预后的独立危险因素。结论 APACHEⅢ、MODS、SOFA、LODS评分有助于对急性脑卒中合并发多器官功能障碍综合征患者做出预后判断,高血糖、C反应蛋白、基础疾病是影响预后的独立危险因素。
Objective To compare the APACHE Ⅲ, MODS, SOFA, LODS scores of patients with acute stroke and multiple organ dysfunction syndrome of different prognosis, and analyze the clinical characteristics and mortality risk factors, pro- vide reference for reducing the mortality rate. Methods A total of 134 patients with acute stroke patients and multiple or- gan dysfunction syndrome from December 2011 to September 2013 in our department were retrospectively analyzed. Based on the prognosis, the patients were divided into death group and survive group. All patients were evaluated by acute physi- ology and chronic health evaluation Ⅲ （APACHE Ⅲ ）, multiple organ dysfunction score（ MODS）, sequential organ failure assessment （SOFA） score, Logistic Organ Dysfunction Rating（ LODS score）. And logistic regression analysis was used to analyzed the factors of APACHE Ⅲ score, MODS score, SOFA score, LODS scores, blood glucose levels, C-reactive protein levels, underlying diseases integral multivariate, so to analyzed the prognostic risk factors. Results The age, APACHE Ⅲ, MODS, SOFA, LODS in the survive group were significantly lower than that of death group （ P 〈 0.05 ）. The logistic re- gression analysis results showed that blood glucose 〉 7.8 mmol/L, C-reactive protein, underlying diseases score, APACHE Ⅲ ,MODS,LODS,SOFA were the independent risk factor for prognosis. Conclusion APACHE Ⅲ ,MODS,SOFA,LODS score are helpful for the prognosis of acute stroke patients with multiple organ dysfunction syndrome, and high blood glu- cose, C-reactive protein, underlying diseases score were the independent risk factor for prognosis.
出处
《中华全科医学》
2016年第1期55-56,59,共3页
Chinese Journal of General Practice
基金
浙江省温州市科技局基金资助项目(Y20100034)
