肾综合征出血热危重度评分对患者预后的评价

山东大学学报(医学版) ›› 2012, Vol. 50 ›› Issue (11): 67-70.

肾综合征出血热危重度评分对患者预后的评价

郭楠1，崔速南2，王晓燕2，崔海彬1，汪明明2，公彦雪1

1.山东大学医学院，济南 250012； 2.济南市传染病医院感染科，济南 250021

收稿日期:2012-02-20 出版日期:2012-11-10 发布日期:2012-11-10
通讯作者: 汪明明(1956- )，男，主任医师，硕士生导师，主要从事传染病、肝病研究。 E-mail:wmmcsn@163.com
作者简介:郭楠(1987- )，女，硕士研究生，主要从事传染病、肝病研究。

Role of hemorrhagic fever with renal syndrome(HFRS)critical score in
predicting the prognosis for patients with HFRS

GUO Nan1, CUI Su-nan2, WANG Xiao-yan2, CUI Hai-bin1, WANG Ming-ming2, GONG Yan-xue1

1. School of Medicine, Shandong University, Jinan 250012, China;
2. Department of Infectious Diseases, Jinan Hospital of Infectious Diseases， Jinan 250021, China

Received:2012-02-20 Online:2012-11-10 Published:2012-11-10

摘要/Abstract

摘要：

目的探讨肾综合征出血热(HFRS)危重度评分对HFRS患者预后的评价作用。方法研究对象为120例确诊为HFRS的患者，按预后情况分为存活组(90例)和死亡组(30例)。选择全身炎症反应综合征(SIRS)状态、外渗程度、血浆胶体渗透压、血小板计数和尿蛋白等5个参数组成HFRS危重度评分，并通过受试者工作特征曲线(ROC)与感染相关器官衰竭评估(SOFA)、简化急性生理学评分(SAPSⅡ)进行预后预测能力的比较。结果在HFRS危重度评分5个参数的单项评分中，死亡组的记分均高于存活组。HFRS死亡组的SOFA、SAPSⅡ评分和HFRS危重度评分均高于存活组(P<0.01)。SOFA、SAPSⅡ评分和HFRS危重度评分的曲线下面积(AUC)分别为0.704、0.731和0.804。Youden指数以HFRS危重度评分为最高，当取截断值为10时，其预测HFRS患者住院期间死亡风险的敏感性为78.8%、特异性为77.4%。结论 SOFA、SAPSⅡ评分和HFRS危重度评分对HFRS预后均具有良好的评价作用，其中以HFRS危重度评分更为简捷、预测能力最佳。

关键词: 肾综合征出血热；危重度评分； SOFA评分；SAPSⅡ评分；受试者工作特征曲线

Abstract:

Objective To investigate the role of hemorrhagic fever with renal syndrome(HFRS)critical score in predicting the prognosis for patients with HFRS. Methods A total of 120 patients diagnosed as HFRS were divided into the survival group (90 cases) and the death group (30 cases) according to the prognosis. HFRS critical score consisted of SIRS state, extravasation, plasma colloid osmotic pressure, platelet count and urinary protein. The results of HFRS critical score were compared with the SOFA score and the SAPS Ⅱ score. Results All of the five parameters of HFRS critical scores in the death group were significantly higher than those in the survival group. The score of HFRS critical score, SOFA scores and SAPS Ⅱ score in the death group were significantly higher than those in the survival group(P<0.01). The area under the curve (AUC) of SOFA score, SAPS Ⅱ scores and HFRS critical score was 0.704, 0.731 and 0.804 respectively. The Youden index of the HFRS critical scores was the highest (P<0.01) among all three scores . If HFRS critical score 10 was used as the cut off value, the specificity and the sensitivity for predicting the death risk for the patient in admit was respectively 77.4% and 78.8%. Conclusion HFRS critical score, SOFA score, and SAPS Ⅱ score can all effectively predict prognosis for HFRS patients, among which the HFRS critical scores are more easy and convenient , and have the best predictive value.

Key words: Hemorrhagic fever with renal syndrome; Critical score; SOFA score; SAPS Ⅱ score; Receiver operating characteristic curve

中图分类号:

R512.8

郭楠1，崔速南2，王晓燕2，崔海彬1，汪明明2，公彦雪1. 肾综合征出血热危重度评分对患者预后的评价[J]. 山东大学学报(医学版), 2012, 50(11): 67-70.

GUO Nan1, CUI Su-nan2, WANG Xiao-yan2, CUI Hai-bin1, WANG Ming-ming2, GONG Yan-xue1. Role of hemorrhagic fever with renal syndrome(HFRS)critical score in
predicting the prognosis for patients with HFRS[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(11): 67-70.

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