危重病患者死亡风险预测:胃粘膜pH与新型简化急性生理评分的比较

PREDICTION OF PROGNOSIS IN CRITICALLY ILL PATIENTS:COMPARISON OF INTRAMUCOSAL pH ADN NEW SIMPLIFIED SEVERITY SCORE(SAPSⅡ)

观察了８７ 例患者入ＩＣＵ 后第１ 个２４ｈ 内的胃粘膜内ｐＨ（ｐＨｉ）和新型简化急性生理评分（ＳＡＰＳⅡ）。１１ 例（１２．６％ ）患者在ＩＣＵ治疗期间死亡。死亡组患者的ｐＨｉ为７．０３±０．２７，存活组ｐＨｉ为７．４２±１３，两组相比，死亡组ｐＨｉ显著低于成活组（Ｐ＜ ０．０１）。死亡组的ＳＡＰＳⅡ（４５±１１．７７）则显著高于存活组（１９．５８±１０．３２），两组差异有非常显著性意义（Ｐ＜ ０．０１）。从ＳＡＰＳⅡ值计算的病死率，１１ 例死亡患者中６ 例（５４．４％ ）＞５０％ ，而所有１１ 例死亡患者中，９例（８１．８％ ）ｐＨｉ＜ ７．３２。作者推论，在估计危重病患者个体死亡时，ｐＨｉ较ＳＡＰＳⅡ更有价值。

In 87 ICU patients intramucosal pH (pHi) was measured, and the new simplified acute physiology score (SAPSⅡ) was calculated within the first 24h ICU admission. Eleven(12 6%) patients died in the ICU.The nonsurvivors had a relatively lower pHi(7 03±0 27) and a higher SAPSⅡ(45±11 77),while the svrvivors had a higher pHi (7 42±0 13) and a lower SAPSⅡ(19 58±10 32).The difference was statistically significant( P <0 01). Six(54 4%) of the nonsurvivors had a higher than 50% probability of mortality by SAPSⅡ scoring. While 9(81 81%) of the nonsurvivors had a lower pHi than 7 32. It was concluded that pHi was more valuable than SAPSⅡ in the evaluation of probability of mortality for ICU Patients.