目的 探讨急性生理学和慢性健康状况(APACHEⅡ、APACHEⅢ)评分、改良爱丁堡—斯堪的纳维亚评分(CSS)、美国国立卫生研究所脑卒中评分(NIHSS)、欧洲卒中评分(ESS)、既往史和伴发疾病评分与急性脑梗死患者预后的关系.方法 对441例急性脑梗死患者在入院24 h内分别进行APACHEⅡ、APACHEⅢ、CSS、NIHSS、ESS、既往史和伴发疾病评分,根据患者发病后1个月时的预后分为生存组和死亡组,并对各组各评分进行统计分析.结果 APACHEⅡ、APACHEⅢ、CSS、NIHSS和伴发疾病评分分值死亡组高于生存组,ESS评分死亡组低于生存组(P均＜0.01).既往史评分生存组和死亡组无统计学意义.多因素Logistic回归分析显示,APACHEⅡ、APACHEⅢ、NIHSS、ESS和伴发疾病评分为急性脑梗死预后的影响因素(P均＜0.05).结论 APACHEⅡ、APACHE Ⅲ、NIHSS、ESS和伴发疾病评分对急性脑梗死患者的预后有较好的预测价值.%Objective To investigate the relationship between APACHE Ⅱ , APACHE Ⅲ, CSS, NIHSS, ESS, complication scale, past history scale and the prognosis in acute cerebral infarction. Methods A total of 441 patients with a-cute cerebral infarction were tested with APACHE Ⅱ , APACHE Ⅲ, CSS, NIHSS, ESS and complication scale after 24 hours admission. All of them were divided into two groups according to the status of survival or death after 1 month of mor-bility. Results A significant difference was found between survivors and non-survivors group on the score of patients scored by APACHEⅡ , APACHEⅢ, NIHSS, CSS, ESS and complication scale respectively (P<0.01). The scores of non-survivors group were higher than those of survivors group by APACHE Ⅱ , APACHE Ⅲ, NIHSS, CSS and complication scale, and lower than that of survivors group by ESS (P < 0.05). The scale of past history had no significant difference between survivors and non-survivors group ( P > 0.05 ). Logistic multivariate regression results showed that APACHE II , APACHEM , NIHSS, ESS and complication scale were all significantly associated with early prognosis of acute cerebral thrombosis. Conclusion APACHE Ⅱ , APACHE Ⅲ, NIHSS, ESS and complication scale are superior to the others in predicting the status of survival or death of acute cerebral thrombosis.
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