不同评分系统对慢性阻塞性肺疾病急性加重患者28天生存率的预测价值
Predictive value of different scoring systems for 28-day survival rate in patients with acute exacerbation of chronic obstructive pulmonary disease

叶世华.不同评分系统对慢性阻塞性肺疾病急性加重患者28天生存率的预测价值[J].内科急危重症杂志,2019,25(5):364-366

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DOI：10.11768/nkjwzzzz20190503

英文关键词:Anti-PD-1 antibody Adverse effects

基金项目:东莞市科学技术局医学科研项目（No：201610515000571）

作者	单位	E-mail
叶世华	东莞市黄江医院	1760103614@qq.com

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中文摘要:

目的：探讨不同评分系统对慢性阻塞性肺疾病急性加重期(AECOPD)患者28d生存率的预测价值。方法：收集AECOPD患者150例，均进行积极常规救治，采用BAP-65评分、急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)及慢性阻塞性肺疾病和支气管哮喘生理评分(CAPS)对28d生存率进行预测。根据预后将患者分为死亡组12例和存活组138例。结果：死亡组患者APACHEⅡ评分与CAPS评分均明显高于存活组（P<0.05），两组BAP-65评分差异有统计学意义（P<0.05）。3种评分系统中APACHEⅡ评分对AECOPD患者28d生存率预测曲线下面积最大，为0.917，且其敏感性及特异性均最大，分别为89.06%及83.88%，CAPS评分与BAP-65评分曲线下面积分别为0.828、0.888，且诊断敏感性及特异性均在70%以上。结论： BAP-65评分、APACHEⅡ评分及CAPS评分对AECOPD患者28d生存率均有较高的预测价值，且APACHEⅡ评分预测价值最佳。

英文摘要:

Objective: To investigate the value of different scoring systems in predicting 28-day survival rate in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: A total of 150 AECOPD patients were enrolled. All patients underwent routine treatment with a BAP-65 score, APACHE II score, and CAPS score to predict 28-day survival. Patients were divided into death group (12 cases) and survival group (138 cases) according to the prognosis of patients. Results: The APACHE II score and CAPS score in the death group were significantly higher than those in the survival group (P<0.05). The difference in BAP-65 scores between the two groups was statistically significant (P<0.05). The ROC results showed that the APACHE II score in the three scoring systems had the largest area under the 28-day survival rate prediction curve for AECOPD patients, and the sensitivity and specificity were 89.06% and 83.88%, respectively. The CAPS score and BAP-65 score curves were obtained. The lower area was 0.828 and 0.888, respectively, and the diagnostic sensitivity and specificity were above 70%. Conclusion: The BAP-65 score, APACHE II score and CAPS score have a higher predictive value for 28-day survival rate in patients with AECOPD, and the predictive value of the APACHE II score is the highest.