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目的 评估急性生理学和慢性健康状态评分Ⅲ(APACHEⅢ)和急性肺损伤(ALl)评分对严重急性呼吸综合征(SARS)的病情严重程度和预后的价值。方法 对38例重症SARS患者应用APACHEⅢ和ALI评分,并对结果进行比较。结果 死亡组(14例)的APACHEⅢ平均分值为74.9±22.3明显高于存活组(24例)平均分值38.3±13.2(P<0.001),APACHEⅢ各分段值与病死率呈正相关,APACHEⅢ分值≥60分,病死率明显增高(X~2=3.886,P<0.05);老年组(18例)的病死率明显高于非老年组(20例)(X~2=8.660,P<0.05);但死亡组和存活组的ALI评分分值差异无显著性(P=0.127)。结论 APACHE Ⅲ较ALI评分更能准确地判断重症SARS患者病情严重程度和预后;老年人重症SARS的病死率明显升高。
Objective To assess the value of acute physiology and chronic health score Ⅲ (APACHE Ⅲ) and acute lung injury (ALl) scores on the severity and prognosis of severe acute respiratory syndrome (SARS). Methods APACHE Ⅲ and ALI scores were evaluated in 38 patients with severe SARS and the results were compared. Results The average score of APACHE Ⅲ in death group (74.9 ± 22.3) was significantly higher than that in survivors (24 cases) (38.3 ± 13.2) (P <0.001). The values of APACHE Ⅲ were correlated positively with the mortality and APACHE Ⅲ The mortality was significantly higher in the elderly group (18 cases) than in the non-elderly group (20 cases) (X ~ 2 = 8.660, P <0.05) ). However, there was no significant difference in ALI scores between death and survivors (P = 0.127). Conclusion APACHE Ⅲ is more accurate than ALI in judging the severity and prognosis of severe SARS patients. The mortality rate of severe SARS in elderly is significantly higher.