三种评分系统在脓毒性休克预后评估中的应用

目的：探讨APACHEⅡ、SAPSⅡ、SOFA三种评分系统在脓毒性休克预后评估中的临床意义。方法：收集脓毒性休克58例,记录患者的一般情况及预后,并对全部患者入院24 h内进行APACHEⅡ、SAPSⅡ和SOFA评分。根据预后将患者分为死亡组和存活组,并对二组患者的APACHEⅡ、SAPSⅡ和SOFA评分均值及ROC下面积进行比较,APACHEⅡ、SAPSⅡ的预测病死率与实际病死率进行比较。结果：死亡组和存活组比,APACHEⅡ、SAPSⅡ和SOFA评分的均值比较差异有显著性;三种评分ROC下面积分别为：0.681（0.076）、0.730（0.070）、0.747（0.073）。APACHEⅡ预测危险度对预后判断的灵敏度为11.76%,特异度为85.37%;而SAPSⅡ的灵敏度为70.95%,特异度为60.96%。结论：三种评分均可对脓毒性休克患者的预后进行评估;SAPSⅡ预测死亡危险度高于实际病死率。

Application of APACHEⅡ,SAPSⅡ and SOFA evaluating progresis for in evaluating progresis for septic shock patients

Objective： To investigate the effectiveness of APACHE II, SAPS II and SOFA in the prognostic evaluation of septic shock patients. Methods ： Fifty-eight septic shock patients in Emergency ICU were enrolled into this retrospective study. APACHE II, SAPS II and SOFA II counts were obtained within the first 24 hr following EICU admission. Results： Compared with survival group, the points of APACHE II, SAPS II and SOFA were higher （P〈0.05） and area under curve of ROC of them was 0.681（0.076）, 0.730 （0.070） and 0.747 （0.073） respectively. Sensitivity of the APACHE II and SAPS II systems was 11.76% and 70.95%, respectively. Specificity of the APACHE II and SAPS II systems was 85.37% and 60.96%, respectively. Conclusion ：APACHE II , SAPS II and SOFA score systems are useful for evaluating the prognosis of septic shock patients. But SAPS II tends to overestimate the hospital death rate of septic shock patients.