APACHEⅡ评分对重症肺炎致急性肺损伤患者撤机结局的预测价值

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英文篇名：Predictive value of APACHE Ⅱ score in weaning outcome of patients with acute lung injury caused by severe pneumonia 作者：甘惠玲 ; 赵双平 英文作者：GAN Hui-ling;ZHAO Shuang-ping;Xiangya Hospital of Central South University; 关键词：重症肺炎 ; 急性肺损伤 ; 撤机 ; APACHEⅡ评分 ; 机械通气 ; 预测价值 英文关键词：Severe pneumonia;;Acute lung injury;;Weaning;;APACHEⅡ score;;Mechanical ventilation;;Predictive value 中文刊名：NKJW 英文刊名：Journal of Critical Care in Internal Medicine 机构：中南大学湘雅医院; 出版日期：2019-04-15 出版单位：内科急危重症杂志 年：2019 期：v.25 语种：中文; 页：NKJW201902010 页数：3 CN：02 ISSN：42-1394/R 分类号：37-39

摘要

目的:探讨APACHEⅡ评分对重症肺炎致急性肺损伤患者撤机结局的预测价值。方法:回顾性分析60例行机械通气患者的临床资料,依据48 h内的撤机结局,将研究病例分为撤机失败组与撤机成功组,比较2组入院时及撤机前APACHEⅡ评分、自主呼吸实验(SBT)前机械通气时间,并进行相关性分析,以评估APACHEⅡ评分对重症肺炎致急性肺损伤患者撤机结局的预测效果。结果:60例中,35例撤机成功,25例撤机失败,2组在患者年龄、性别、SBT前通气时间、入院时APACHEⅡ评分比较差异无统计学意义(P>0.05);撤机成功组撤机前APACHEⅡ评分明显低于撤机失败组(P<0.05);APACHEⅡ评分最佳截点值为(10.64±1.85)分,ROC曲线下面积(AUC)为(0.885±0.126),相关性分析结果显示,撤机前APACHEⅡ评分在撤机成功评估的特异性为25.4%,敏感度为86.5%。结论:APACHEⅡ评分对重症肺炎致急性肺损伤患者撤机结局具有较高的敏感度,可作为重症肺炎致急性肺损伤患者机械通气撤机的重要参考值。
        Objective: To investigate the predictive value of APACHEⅡ score in weaning outcome of patients with acute lung injury caused by severe pneumonia. Methods: A total of 60 patients given mechanical ventilation were retrospectively analyzed. According to the weaning outcome within 48 h, the included cases were divided into two groups: the weaning failure group and the weaning success group. APACHE II score on the first day after admission, time of mechanical ventilation before SBT and APACHEⅡ score before weaning were compared between two groups, and the correlation analysis was done to evaluate the predictive value of APACHEⅡ score in the weaning outcome of patients with acute lung injury induced by severe pneumonia. Results: Among the 60 cases, 35 patients had weaning success and 25 patients had weaning failure. There was no significant difference between the two groups in age, gender, pre-SBT ventilation time and APACHEⅡ score on the first day after admission(P>0.05). APACHEⅡ score before weaning was significantly lower in weaning success group than that of weaning failure group(P<0.05). The optimal cut-off value of APACHEⅡ score was(10.64 ± 1.85), and area under ROC curve(AUC) was(0.885 ± 0.126). The correlation analysis showed that the specificity of APACHEⅡ score before weaning was 25.4% and the sensitivity was 86.5%. Conclusion: The application of APACHEⅡ score in acute lung injury induced by severe pneumonia is of great value in predicting weaning outcome, which can be used as an important reference for weaning from mechanical ventilation in patients with acute lung injury caused by severe pneumonia.

引文

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