APACHEⅡ评分对急性重症有机磷中毒患者预后判断的价值

Prognostic value of APACHEⅡscore in patients with severe acute organophosphorus poisoning

目的探讨急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ评分)对急性重症有机磷中毒患者预后判断的价值。方法选择急性重症有机磷中毒患者42例,其中存活34例、死亡8例,收集患者入院后24h内APACHEⅡ评分,并进行受试者工作特征曲线(ROC曲线)分析。结果 42例急性重症有机磷中毒患者APACHEⅡ评分为18～30分,平均(20.11±6.32)分,其中存活组为(16.10±3.12)分、死亡组为(28.01±4.46)分,两组比较差异有统计学意义(P<0.01)。随着APACHEⅡ评分的增高,急性重症有机磷中毒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0.922,APACHEⅡ评分21.2分为最佳诊断界点,其敏感性和特异性分别为95%、89%。结论 APACHEⅡ评分能预测急性重症有机磷中毒患者的严重程度,并可以协助判断患者预后,APACHEⅡ评分大于或等于21.2分可作为患者死亡的预警指标。

Objective To explore the prognostic value of APACHE Ⅱscore in patients with Severe acute organophosphorus poi-soning .Methods 42 patients with Severe acute organophosphorus poisoning ,in which 34 cases survived ,8 cases dead ,were select-ed .The APACHE Ⅱscores of patients in first 24 h of admission were collected ,and receiver operating characteristic curves （ROC curve） were drawn .Results APACHE Ⅱ score of the 42 patients with Severe acute organophosphorus poisoning was 18 ~30 （20 .11 ± 6 .32） ,in which the survival group was（16 .10 ± 3 .12） ,the dead group was（28 .01 ± 4 .46） （P〈0 .01） .With the increase of APACHE Ⅱ score ,the fatality rate gradually increased .The total area under the ROC curves of APACHE Ⅱ score for death judgment was 0 .922 ,APACHE Ⅱ score of 21 .2 was the best diagnostic point ,the sensitivity was 95% ,and specificity was 89% . Conclusion The APACHE Ⅱscore could predict severity of patients with Severe acute organophosphorus poisoning ,and APACHEⅡscore ≥21 .2 could be used as the prognosis for death of the patients .