多器官功能障碍综合征病情严重度评分系统

Scoring System to Measure the Severity of the Multiple Organ Dysfunction Syndrome

目的建立多器官功能障碍综合征(MODS)病情严重度评分系统。方法收集MODS临床资料,通过统计分析筛选出反映脏器功能的指标并赋予各指标反映病情严重程度的等级分值,分值范围为0～4分,0分表示脏器功能正常,1～4分表示脏器功能障碍至衰竭,据此建立MODS病情严重度评分系统。结果对MODS临床资料进行单因素和多因素统计学分析,筛选出收缩压、氧合指数、意识状态、外周血血小板计数、血总胆红素浓度、血肌酐浓度及肠鸣音、消化道出血情况作为反映心血管、肺、脑、凝血、肝脏、肾脏和胃肠7个脏器系统功能状态的指标,结合所赋予的等级分值,建立MODS病情严重度评分系统。根据患者各指标的实际情况对各脏器功能进行评分,将各脏器功能状态的评分分值相加后得到MODS总分,总分值最高为24分。MODS评分与病死率的关系显示,随着MODS总分的增加,病死率显著增加(P<0.001)。结论本评分系统可用于评价MODS患者的病情严重程度。

Objective To develop a scoring system to measure the severity of the multiple organ dysfunction syndrome （MODS）. Methods The clinical data of patients with MODS were collected and analyzed prospectively. Seven indicators were screened out to assess the functions of seven organs. Each indicator was scored from 0 to 4 points, with the 0 point representing the normal organ function, and 1 point to 4 points representing the dysfuntion to failure of the organ. Acording to the index and points a severity scoring system were developed. Results Seven indicators including the systolic pressure, oxygenation index, conscious state, peripheral blood platelet count, blood total bilirubin, and serum creatinine were used to represent the functions of seven organs. The seven organs included cardiovascular system, lung, brain, coagulative system, liver, kidney, and gastrointestinal tract. The severity scoring system were composed of seven indicators and their points. The total score was 24 points. The mortality increased along with the increase of the points （ P 〈 0. 001 ）. Conclusion This scoring system can be used to assess the severity of the MODS.