APACHEⅡ评分在急性有机磷农药中毒中死亡风险评估价值研究及回归模型建立

Value of APACHE Ⅱ in evaluation of death risk of acute organophosphorus pesticide poisoning and its regression model establishment

目的 探讨应用急性生理和慢性健康状况评分Ⅱ（APACHEⅡ）评估急性有机磷农药中毒（AOPP）患者的病情危重程度并判断其预后的临床意义.方法 回顾性分析我院AOPP病例72例,分别计算APACHEⅡ评分值,进行验证,Logistic回归分析,建立回归模型.结果.72例患者生存55例,死亡17例,APACHEⅡ评分0～53分,生存组 （14.84±7.08）分,死亡组（33.95±5.07）分,两组比较差异有统计学意义（t=10.74,P＜0.001）.进行Logistic回归分析后得到死亡风险模型.结论.APACHEⅡ评分系统应用于AOPP病情危重程度和预后评估有一定的临床意义,APACHEⅡ评分值越高,死亡风险越高,高分组更能反映实际死亡率,当APACHEⅡ评分值≥28分时患者预后较差.

Objective To study the clinical significance of acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ） in the severity and prognosis assessment of acute organophosphorus pesticide poisoning （AOPP） patients. Methods 72 AOPP cases were analyzed with APACHE Ⅱ retrospectively. Verify and apply Logistic regression analysis to it, and establish the regression model. Results 55 survived and 17 died in 72 cases, APACHE Ⅱ scored 0 - 53. The score of survival group was 14.84 ±7.08, and that of death group was 33.95±5.07. The APACHE Ⅲ difference between the two groups was significant in statistics （t = 10.74 ,P 〈 0. 001 ）. Model of death risk was established with Logistic regression analysis. Conclusion APACHE Ⅱ is of clinical significance in severity and prognosis assessment of AOPP patients. The higher value of APACHE Ⅱ is, the higher risk of death will be faced. And the real death rate is revealed more precisely in high score group. The prognosis of patient is poor when APACHE Ⅱ score is above or equals 28.