APACHE Ⅱ评分对扩张型心肌病患者预后的预测价值研究

The value of APACHE Ⅱ score in prognosis evaluation of patients with dilated cardiomyopathy

目的讨论急性生理与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分对扩张型心肌病(DCM)患者不良预后的预测价值。方法将148例DCM患者按随访期间有无再入院、心源性死亡分为事件组(31例)和无事件组(117例)。采用Cox回归分析DCM患者不良预后的危险因素。结果有事件组APACHEⅡ评分明显高于无事件组(P<0.001)。多因素Cox分析显示,APACHEⅡ评分是校正年龄、性别、LVEF等因素后不良心血管事件的独立危险因素(HR 2.03,95%CI 1.76~2.59,P<0.001)。生存分析显示,APACHEⅡ评分高值组具有较低的无事件生存率(log-rank P=0.003)。结论APACHEⅡ评分与DCM患者不良预后具有相关性,APACHEⅡ评分≥8.6可作为DCM患者不良事件的独立预测因素。

Objective To discuss the predictive value of acute physiology and chronic health scoreⅡ(APACHEⅡ)for adverse prognosis in patients with dilated cardiomyopathy(DCM).Methods 148 patients with DCM were divided into event group(31 cases)and event-free group(117 cases),according to the re-admission and cardiogenic death during follow-up Cox regression was used to analyze the risk factors of adverse prognosis in DCM patients.Results The APACHE II score in the event group was significantly higher than that in the non-event group(13.6±4.4 vs 7.2±3.1,P=0.000).Survival analysis showed that the high APACHEⅡscore group had a lower event-free survival rate(log-rank P=0.003).Conclusion APACHE II score is correlated with adverse prognosis of DCM patients.APACHE II score≥8.6 can be used as an independent predictor of adverse events in DCM patients,which is helpful for risk stratification,prognosis assessment and guidance of individualized treatment.