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目的探讨快速序贯器官衰竭评分(q SOFA评分)在脓毒性休克患者的预后评估中的价值。方法收集急诊重症监护病房2013年1月-2014年1月收治的170例脓毒性休克患者的临床资料,根据28 d转归记录为存活组和死亡组,计算两组入院时q SOFA评分、急性生理学与慢性健康状况评分系统(APACHE)Ⅱ评分,通过受试者工作特征(ROC)曲线分析q SOFA评分、APACHEⅡ评分对脓毒性休克患者28 d内死亡的预测效能,评价q SOFA评分与APACHEⅡ评分的相关性。结果死亡组入院时q SOFA评分、APACHEⅡ评分均高于存活组,根据ROC曲线分析计算死亡组q SOFA评分、APACHEⅡ评分的曲线下面积分别为0.666、0.791。q SOFA评分以2分为截断点评价脓毒性休克预后的灵敏度为62.7%,特异度为61.1%,阳性预测值为56.0%,阴性预测值为67.4%,阳性似然比为1.61,阴性似然比0.61。APACHEⅡ评分以24分为截断点评价脓毒性休克预后的灵敏度为70.7%,特异度为80.0%,阳性预测值为73.6%,阴性预测值为67.3%,阳性似然比为3.54,阴性似然比为0.37。q SOFA评分与APACHEⅡ评分的相关系数为0.499。结论 q SOFA评分在急诊科早期评估脓毒性休克患者的预后有重要价值。
Objective To investigate the value of rapid sequential organ failure score (q SOFA) in the prognosis evaluation of patients with septic shock. Methods The clinical data of 170 patients with septic shock admitted in emergency ICU from January 2013 to January 2014 were collected and recorded as survivors and deaths on 28th day of admission. The scores of q SOFA, Physiology and Chronic Health Evaluation System (APACHE) Ⅱ score, the QSOFA score and APACHE Ⅱ score were used to predict the 28-day mortality in patients with septic shock by ROC curves. The scores of q SOFA and APACHEⅡ Relevance. Results The scores of q SOFA and APACHEⅡ in the death group were higher than those in the surviving group. According to the ROC curve analysis, the area under the curve of q SOFA and APACHEⅡ score were 0.666 and 0.791 respectively. q SOFA score of 2 points for the evaluation of the prognosis of septic shock sensitivity was 62.7%, specificity was 61.1%, positive predictive value was 56.0%, negative predictive value was 67.4%, positive likelihood ratio was 1.61, negative likelihood Than 0.61. APACHE Ⅱ score 24 points for the evaluation of the prognosis of septic shock sensitivity was 70.7%, specificity was 80.0%, positive predictive value was 73.6%, negative predictive value was 67.3%, positive likelihood ratio was 3.54, negative likelihood ratio Is 0.37. The correlation coefficient between q SOFA score and APACHE II score was 0.499. Conclusions The q SOFA score is of great value in early diagnosis of patients with septic shock in the emergency department.