老年人肺部感染并发多器官功能不全综合征的早期预测评分系统研究

目的 建立筛查肺部感染并发老年人多器官功能不全综合征(MODSE)高危人群及其发病的早期预测评分系统.方法 回顾性调查2001年1月至2006年12月因肺部感染在我院住院或住院期间出现肺部感染的驻石家庄地区60岁及以上的军队师以上离退休干部393例的病历资料,根据肺部感染是否诱发MODSE,将所有病例分为MODSE组和非MODSE组,分析年龄、慢性疾病和健康体检有关血检测项目对MODSE发病的影响,从中筛选早期预测MODSE发病的指标,标以一定的分值,建立MODSE早期预测评分系统.结果 年龄、21种慢性疾病和15项血检测项目中经统计学分析结合临床专业知识评价,最终确立了年龄、7种慢性疾病(慢性阻塞性肺疾病、慢性呼吸衰竭、肺间质纤维化、慢性心功能不全、脑血管疾病、糖尿病和慢性肾功能不全)和4项血检测项目(血红蛋白、血白蛋白、血尿素和空腹血糖)作为MODSE早期预测评分系统的评分指标.结论 所建立的MODSE早期预测评分系统评分指标易得、操作简单、易于推广,为筛查肺部感染并发MODSE高危人群及早期预测MODSE发病提供了简易工具.

Study on the scoring system for early predictim of multiple organ dysfunction syndrome induced by pulmonary infection in elderly patients

Objective To establish the scoring system for early prediction of multiple organ dysfunction syndrome (MODSE) induced by pulmonary infection in the elderly. Methods A total of 393 inpatients with pulmonary infection, aged 60 years and over, were enrolled in this study and the data of them from January 2001 to December 2006 were analyzed retrospectively. All patients were divided into MODSE group and non-MODSE group. The effects of age, chronic disease and blood test items of healthy examination on the pathogenesis of MODSE were explored. The early prediction indexes which were selected from age, 21 chronic diseases and 15 blood test items of healthy examination were scored to establish the scoring system for early predicting MODSE. Results The age, chronic obstructive pulmonary disease, chronic respiratory failure, pulmonary fibrosis, chronic cardiac insufficiency, cerebrovascular disease, diabetes, chronic renal failure, hemoglobin, albumin,urea nitrogen and fasting blood glucose were selected to establish the scoring system for early predicting MODSE. Conclusions The scoreing system for early predicting MODSE may be used to screen the high risk population of MODSE induced by pulmonary infection, which is valuable in early prediction of MODSE.