摘要
目的研究急性生理与慢性健康状况评分II（APACHEII）对糖尿病高渗性高血糖状态患者病情评价和治疗预后的价值。方法52例糖尿病高渗性高血糖状态患者，男30例，女22例，平均年龄（76．5±4．6）岁，在急诊抢救室接受治疗。死亡12例，存活40例，病死率23．1％。入院当天和入院后第2天进行APACHEII评分。结果入院当天死亡组的APACHEII评分为（29．1±5．6）分，显著高于高于存活组[（23±2．8），P〈0．01]；入院后第2天死亡组的的APACHEII评分为（25．7±6）分，亦显著高于存活组[（16．4＋23），19〈0．01]。治疗后第2天两组的APACHEII评分虽均明显降低，但是存活组降低的分值为（6．7±1-4）分，显著高于死亡组[（3．4±3．4）分，19〈0．01]。2d的APACHEII评分的接收者特征（ROC）曲线下面积无统计学差异。入院当天区分死亡组和存活组的最佳APACHEII分值为26分，Youden指数为0．63；入院第2天区分死亡组和存活组的最佳APACHEII分值为22分，Youden指数为0．78。结论监测两次APACHEII评分能较好地评价糖尿病高渗性高血糖状态患者的病情和预后。
Objective To investigate the value of acute physiology and chronic health evaluation II （APACHEII） score in prediction of prognosis of diabetic hyperglycemic hyperosnmlar state. Methods Fifty-two patients with diabetic hyperglycemic hyperosmolar state, aged 75.5, were admitted into the emergency room of which 12 died later. APACHEII score was recorded on the day of admission and the day 2 afier admission respectively. Results The APACHEII score on the day of admission of the death group was （29.1 ± 5.6）, significantly higher than that of the survival group [（23± 2.8）, P〈0.01]）.The APACHEII score on the day 2 after admission of the death group was （25.7 ±6）, also significantly higher than that of the the survival group [（16.4±2.3）, P〈0.01]. The APACHEII scores were reduced significantly in both groups within 2 days, however, the reduction value of the survival group was （6.7± 1.4）, significantly greater than that of the death group [（3.4±3.4）, P〈0.01 ]. There was no significant difference in the area under receiver operating characteristic curve for APACHE II score between the day of admission and the day 2. The best cutoff point for APACHE II score was 26 at admission, and 22 on the day 2. The best cutoff point for Youden index was 0.63 at admission, and 0.78 on the day 2. Conclusion The change of APACHEII score helps predict the severity and outcome of diabetic hyperglycemic hyperosmolar state.
出处
《中国急救复苏与灾害医学杂志》
2010年第4期338-340,共3页
China Journal of Emergency Resuscitation and Disaster Medicine
关键词
APACHEII评分
糖尿病高渗性高血糖状态
Acute physiology and chronic health evaluation II （APACHE II）
Diabetic hyperglycemic hyperosmolar state
