CPIS与APACHE Ⅱ评分对无创通气治疗慢性阻塞性肺疾病急性发作并呼吸衰竭的疗效预测

目的 探讨通过临床肺部感染评分(CPIS)和急性生理和慢性健康状况Ⅱ(APACHEⅡ)评分判断无创通气治疗慢性阻塞性肺疾病急性发作(AEc0PD)并呼吸衰竭的疗效.方法 对67例AECOPD并呼吸衰竭患者的临床资料进行分析,计算CPIS和APACHEⅡ评分,观察不同CPIS和APACHEⅡ评分患者的气管插管率和病死率.结果 CPIS≥8分、APACHE Ⅱ评分≥25分的患者气管插管率、病死率较高,差异有统计学意义(P<0.01);两种评分其曲线下面积均在0.90以上,具有较高的分辨能力.结论 可根据CPIS和APACHEⅡ评分确定AECOPD并呼吸衰竭患者选择气管插管的时机,对评估和预测预后有一定价值.

The predictive value of CPIS and APACHE Ⅱ for the efficacy of noninvasive ventilation therapy in patients with acute exacerbations of chronic obstructive pulmonary disease

Objective To evaluate the value of clinical pulmonary infection score (CPIS) and acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) in predicting the efficacy of noninvasive ventilation therapy in patients with acute exacerbations of chronic obstructive pulmonary disease(AECOPD). Methods The clinical data of 67 AECOPD patients with respiratory failure were analyzed with CPIS and APACHE Ⅱ were calculated respectively. The trachea cannula and death rates of patients with different CPIS and APACHE Ⅱ were observed. Results CPIS≥18 scores and APACHE Ⅱ≥25 scores indicated higher trachea cannula and death rates (P< 0.01).The area under the curve was above 0.90 in both CPIS and APACHE Ⅱ . Conclusions CPIS and APACHE Ⅱ can be helpful in giving timely trachea eannula to AECOPD patients with respiratory failure. CPIS and APACHE Ⅱ play important roles in evaluation and forecasting prognosis.