摘要
目的:探讨CURB-65、PSI、APACHEⅡ评分在评估重症肺炎(SP)患者预后中的应用价值。方法:选取2016年11月至2018年10月广州医科大学附属第三医院收治的108例SP患者,依据生存预后分为死亡组(48例)和生存组(60例),同期选取非SP患者50例作为对照组。分析CURB-65、PSI、APACHEⅡ评分对SP患者预后的评估价值。结果:SP患者CURB-65、PSI、APACHEⅡ评分明显高于非SP患者(P<0.05);死亡组CURB-65、PSI、APACHEⅡ评分明显高于生存组(P<0.05); ROC曲线分析显示,在评估SP患者死亡预后的敏感度、特异度、准确度中,CURB-65>3分时为83.33%,85.00%,84.26%,PSI>120分时为84.25%,83.33%,82.41%,APACHEⅡ>17分时为87.50%,85.00%,86.11%,三者联合时为95.83%,96.67%,96.30%,三者联合明显高于三者单独(P<0.05)。结论:CURB-65、PSI、APACHEⅡ评分与SP病情及预后有关,均可作为评估患者预后的重要方法,且三者联合时评估效能更佳。
Objective: To investigate the value of CURB-65,PSI and APACHE II scores in evaluating the prognosis of patients with severe pneumonia( SP). Methods: Included in this study were 108 SP patients admitted to Third Affiliated Hospital of Guangzhou Medical University between November 2016 and October 2018.According to survival prognosis,they were assigned to the death group( n = 48) and survival group( n = 60). A contemporary cohort of 50 non-SP patients were selected as control group. The value of CURB-65,PSI,and APACHE II scores in evaluating the prognosis of SP patients was investigated. Results: The CURB-65,PSI and APACHE II scores in the SP patients were significantly higher than those in the non-SP patients( P<0.05). The CURB-65,PSI and APACHEII scores in the death group were significantly higher than those in the survival group( P<0.05). ROC curve analysis showed that sensitivity,specificity and accuracy for predicting death in the SP patients were: 83.33%,85.00% and 84.26% based on CURB-65 score> 3; 84.25%,83.33% and 82.41% based on PSI score >120; 87.50%,85.00% and 86.11% based on APACHE II > 17; 95.83%,96.67% and 96.30%when the three were used in combination. These data were higher when the three were used in combination than any one used alone( P < 0. 05). Conclusion: CURB-65,PSI,APACHE II scores are related to severity and prognosis of SP,and can be used as important tools to predict the prognosis of patients. The prediction efficiency seems better with the three used in combination.
引文
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