C-反应蛋白联合APACHE Ⅱ评分在危重病患者预后评价中的意义

Significance on the C-reactive protein combined with APACHE Ⅱ score in the prognosis evaluation of patients with critical illness

目的探讨C-反应蛋白(CRP)联合APACHEⅡ评分在危重病患者预后评价中的临床意义。方法选取2012年2月至2014年6月于本院ICU进行诊治的82例危重病患者为研究对象,将所有患者的血清CRP水平及APACHEⅡ评分进行分别统计,将其中不同CRP水平或APACHEⅡ评分者的APACHEⅡ评分或CRP水平、病死率、MODS发生率、呼吸机通气时间和住院天数进行比较,同时分析单纯CRP、APACHEⅡ评分及联合检测的特异度及敏感度、阳性预测值和阴性预测值。结果 CRP水平较高者的APACHEⅡ评分、病死率、MODS发生率、呼吸机通气时间和住院天数均高于CRP水平较低者,APACHEⅡ评分较高者的CRP水平、病死率、MODS发生率、呼吸机通气时间和住院天数均高于APACHEⅡ评分较低者,以上各项观察指标比较差异均有统计学意义(P<0.05),且联合检测的特异度及敏感度、阳性预测值、阴性预测值均高于单项,差异均有统计学意义(P<0.05)。结论 CRP联合APACHEⅡ评分对危重病患者的预后有较高的预测价值。

Objective To study and investigate the clinical significance of C-reactive protein（CRP） combined with APACHE Ⅱ score in the prognosis evaluation of patients with critical illness. Methods Eighty-two patients with critical illness in ICU of our hospital from February 2012 to June 2014 were selected as research objects.The CRP levels and APACHE Ⅱ score of all the patients were respectively analyzed, and the APACHE Ⅱ score or CRP levels, mortality, MODS rates, mechanical ventilation time and hospitalization time of patients with different CRP levels or APACHE Ⅱ score, and the specificity, sensitivity, positive predictive value and negative predictive value of only CRP, APACHE Ⅱ score and two methods were analyzed. Results The APACHE Ⅱ score, mortality,MODS rates, mechanical ventilation time and hospitalization time of patients with higher CRP levels were higher than those of patients with lower CRP levels. The CRP levels, mortality, MODS rates, mechanical ventilation time and hospitalization time of patients with higher APACHE Ⅱ score were higher than those of patients with lower APACHE Ⅱscore. There was significant differences in all the above indexes（P〈0.05）. The specificity, sensitivity, positive predictive value and negative predictive value of two methods combined were all higher than those of one method, with statistically significant differences（P〈0.05）. Conclusion The clinical significance of CRP combined with APACHE Ⅱscore in the prognosis evaluation of patients with critical illness is higher, and it has higher predictive value for the prognosis.