MODS评分与应激性溃疡的相关性研究

Study of the correlation between MODS score and incidence of stress ulcer

目的 预测多器官功能障碍综合征（multiple organ dysfunction syndrome,MODS）患者应激性溃疡的发生,为其预防治疗提供依据.方法 回顾性分析2008年8月至2012年8月入住南京军区南京总医院急诊重症监护病房（emergency intensive care unit,EICU）的符合MODS诊断标准的262例患者的临床资料.根据Marshall的MODS评分标准进行评分,依据应激性溃疡诊断标准判断应激性溃疡的发生,用秩相关分析MODS评分与应激性溃疡发生的相关性,应用受试者工作特征曲线（receiver operating characteristic curve,ROC）评价MODS评分对应激性溃疡的预测作用,计算Youden指数确定最佳临界值.结果 Spearman相关系数为0.693 （P ＜0.01）,ROC下面积为0.793 （P ＜0.01）,预测应激性溃疡的MODS评分最佳临界值为9分.结论 MODS评分能在一定程度上预测应激性溃疡的发生,MODS评分＞9分时应进行应激性溃疡的预防治疗.

Objective To investigate the incidence of stress ulcer in MODS patients in order to find a rationale for prophylaxis.Methods Clinical data of two hundred and sixty-two patients met the MODS diagnosis criterionadmitted to our EICU from August 2008 to August 2012 were retrospectively analyzed.The MODS score criterion proposed by Marshall was used to estimate all MODS patients.The stress ulcer was identified according to the diagnosis criterion of stress ulcer.Correlation between the score and incidence of stress ulcer was studied by rank test.The validity of MODS score to predict the incidence of stress ulcer was to verify with ROC.Optimization of critical value was obtained by Youden＇s index.Results Spearman correlation coefficient was 0.693 （P ＜ 0.01）.The area under the ROC was 0.793 （P ＜ 0.01）.The optimized critical value to predict the incidence of stress ulcer was 9.Conclusions The incidences of stress ulcer can be predicted to a certain extent by MODS score.Stress ulcer prophylaxis is necessary when the MODS score is above 9.