APACHEⅡ评分对重症中暑患者预后判断的价值

摘要

Objective To explore the prognostic value of APECHE Ⅱscore in patients with severe heat stroke. Meth-ods 40 patients with heatstroke, in which 31 cases survived, 9 cases dead, were seleced. The APECHE II scores of patients in first 24 h of admission were collected, and receiver operating characteristic curves ( ROC curve) werer drawn. Results APACHE II score of the 40 patients with heatstroke was 6 ~32 (15.51 ±7.62), in which the survival group was (12.32 ±5.03) , the dead group was (26.13 ±4. 34) (P < 0.01). With the increase of APACHE Ⅱ score, the fatality rate gradually increased. The total area under the ROC curves of APECHE II score for death judgment was 0. 976, APECHE II score of 19.5 was the best diagnostic point, the sensitivity was 100% , and specificity was 86.7%. Conclu-sions The APACHE II score could predict severity of patients with heatstroke, and APACHE Ⅱ scored 19. 5 could be used as the prognosis for death of the patients.%目的 探讨急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ评分)对重症中暑患者预后判断的价值.方法 选择重症中暑患者40例,其中存活31例、死亡9例.收集其入院24h内APACHEⅡ评分,并进行受试者工作特征曲线(ROC曲线)分析.结果 40例重症中暑患者APACHEⅡ评分为6～32(15.51±7.62)分,其中存活组为(12.32+5.03)分、死亡组为(26.13 +4.34)分,两组比较P＜0.01.随着APACHEⅡ评分的增高,重症中暑患者病死率逐渐升高.APACHEⅡ评分对死亡判断的ROC曲线下总面积为0.976,APACHEⅡ评分19.5分为最佳诊断界点,其敏感性和特异性分别为100％、86.7％.结论 APACHEⅡ评分能预测重症中暑患者的严重程度,APACHEⅡ评分≤19.5分可作为患者预后死亡的预警指标.