目的:探讨外周血平均血小板体积/淋巴细胞计数(MPVLR)联合APACHE II评分对脓毒症患者预后的预测价值。方法:采用回顾性队列研究方法,选择该院2020年8月至2023年8月收治的符合脓毒症3.0诊断标准的患者。根据脓毒症患者的28 d预后情况分...目的:探讨外周血平均血小板体积/淋巴细胞计数(MPVLR)联合APACHE II评分对脓毒症患者预后的预测价值。方法:采用回顾性队列研究方法,选择该院2020年8月至2023年8月收治的符合脓毒症3.0诊断标准的患者。根据脓毒症患者的28 d预后情况分为生存组及死亡组。收集患者的临床资料及确诊脓毒症后24 h内血小板体积(MPV)、淋巴细胞(LYM)计数的最差值,并计算平均血小板体积/淋巴细胞计数(MPVLR)、APACHE II评分及SOFA评分。随后使用多因素Logistic回归分析,确定脓毒症患者预后的影响因素,再构建受试者工作特征曲线,评估各项指标对脓毒症患者预后的预测价值。结果:共纳入患者127例,生存组患者76例,死亡组患者51例。死亡组患者更易合并慢性阻塞性肺疾病,且平均血小板体积(MPV)、平均血小板体积/淋巴细胞计数(MPVLR)、APACHE II评分、SOFA评分、及年龄均高于生存组,且差异具有统计学意义(P Objective: To investigate the prognostic value of the mean platelet volume (MPV)-to-lymphocyte ratio (MPVLR) combined with the APACHE II score in predicting the outcomes of patients with sepsis. Methods: This retrospective study screened patients with sepsis who were hospitalized in our hospital, from August 2020 to August 2023 were included and categorized into the survival group and the non-survival group based on 28-day outcomes of sepsis patients. Clinical date and the worst of mean platelet volume (MPV), lymphocyte (LYM) count values within 24 hours of sepsis diagnosis were collected, MPVLR and APACHE II scores were calculated. Multifactorial logistic regression analysis was used to identify risk factors affecting the prognosis of sepsis patients, and then a subject operating characteristic curve (ROC) was constructed to assess the predictive value of each indicator on the prognosis of sepsis patients. Results: A total of 127 patients were included, with 76 in the survival group and 51 in the non-survival group. Patients in the non-survival group were more likely to have chronic obstructive pulmonary disease, and had significantly higher MPV, MPVLR, APACHE II scores, SOFA scores and age compared to the survival group (P < 0.05). In contrast, peripheral blood lymphocyte counts in the survival group were significantly higher than that in the non-survival group (P < 0.05). Multivariate logistic regression analysis showed that MPVLR and APACHE II scores were independent risk factors for 28-day mortality in sepsis patients (P < 0.05). Receiver operating characteristic curve (ROC) curve analysis showed that the area under the curve (AUC) values for MPVLR, APACHE II scores, and their combination were 0.840, 0.800, and 0.885, respectively. Notably, the MPVLR combined with the APACHE II score showed the best predictive value, with an AUC of 0.824. It demonstrated excellent predictive performance, achieving a sensitivity of 94.6% and a specificity of 82.4%. Conclusion: APACHE II scores and MPVLR are independent risk factors for 28-day mortality in sepsis patients, and their combined use provides higher predictive value.展开更多
分析急性生理与慢性健康评分(APACHE-Ⅱ评分)、红细胞体积分布宽度(red cell volume distribution width,RDW)及氨基末端脑利钠肽前体(NT-proBNP)与脓毒症患者预后的相关性。选取72例脓毒症患者作为研究对象,患者的入院时间为2022年1月...分析急性生理与慢性健康评分(APACHE-Ⅱ评分)、红细胞体积分布宽度(red cell volume distribution width,RDW)及氨基末端脑利钠肽前体(NT-proBNP)与脓毒症患者预后的相关性。选取72例脓毒症患者作为研究对象,患者的入院时间为2022年1月—2023年12月,按照存活与否将患者分为存活组(n=58)和病亡组(n=14),对比存活组与病亡组患者的APACHE-Ⅱ评分、RDW及NT-proBNP指标。结果显示,存活组与病亡组脓毒症患者的APACHE-Ⅱ评分、RDW及NT-proBNP差异显著,存活组脓毒症患者的APACHE-Ⅱ评分、RDW及NT-proBNP更优,差异有统计学意义(P<0.05)。BNP浓度越高,APACHE-Ⅱ评分越高,BNP浓度与APACHE-Ⅱ评分成正比。研究发现,APACHE-Ⅱ评分、RDW及NT-proB-NP与脓毒症患者的预后具有相关性。展开更多
目的探讨APACHE-O评分系统(APACHE-II+肥胖指标评分)对急性重症胰腺炎的预测价值。方法2004年1月1日至2006年1月1日间急性胰腺炎患者142例,根据体重指数(body mass index,BMI)分组,把BMI≥26kg/m归为肥胖组,BMI<26kg/m归为非肥胖组...目的探讨APACHE-O评分系统(APACHE-II+肥胖指标评分)对急性重症胰腺炎的预测价值。方法2004年1月1日至2006年1月1日间急性胰腺炎患者142例,根据体重指数(body mass index,BMI)分组,把BMI≥26kg/m归为肥胖组,BMI<26kg/m归为非肥胖组。比较两组患者病情严重程度及并发症等发生情况。分别计算入院24h内APACHE-Ⅱ和APACHE-O评分在不同临界点对急性重症胰腺炎预测的敏感性、特异性、阳性预测值、阴性预测值和准确性,绘制APACHE-II和APACHE-O评分受试者工作曲线(receive-operating curves,ROC)。通过比较ROC的曲线下面积(area under the curve,AUC)来比较两评分系统的预测准确性。结果肥胖组中急性重症胰腺炎患者比例显著高于非肥胖组(P<0.05),肥胖组中胰腺坏死、胰腺假性囊肿及肺功能衰竭发生率显著高于非肥胖组(P<0.05)。取临界点为8时,APACHE-Ⅱ和APACHE-O评分对急性重症胰腺炎预测的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为78.9%,85.4%,45.5%,96.3%,84.5%和78.9%,82.1%,40.5%,96.2%,81.7%。APACHE-Ⅱ和APACHE-O评分的ROC的AUC分别为0.864和0.870,提示APACHE-O评分对重症胰腺炎预测价值稍高于APACHE-Ⅱ评分。结论肥胖型急性胰腺炎患者预后更差。与入院时A-PACHE-Ⅱ评分比较,APACHE-O评分对急性重症胰腺炎的预测价值略高于APACHE-II,为理想的急性重症胰腺炎预测系统。展开更多
Objective: To explore the application effect of nursing interventions based on APACHE II scores in patients with severe pancreatitis and its impact on the recovery time of the gastrointestinal function. Methods: A tot...Objective: To explore the application effect of nursing interventions based on APACHE II scores in patients with severe pancreatitis and its impact on the recovery time of the gastrointestinal function. Methods: A total of 86 patients with severe pancreatitis treated in our hospital from March 2023 to March 2024 were selected. Using a random number table method, the patients were divided into a control group receiving conventional nursing care and a study group receiving nursing interventions based on APACHE II scores, with 43 patients in each group. The intervention effects of the two groups were compared. Results: The recovery time of gastrointestinal function in the study group was significantly shorter than that in the control group (P < 0.05). After the intervention, the quality of life scores in the study group was significantly higher than those in the control group (P < 0.05). The incidence of complications in the study group was significantly lower than in the control group (P < 0.05). Conclusion: Nursing interventions based on APACHE II scores can shorten gastrointestinal recovery time and reduce complications in patients with severe pancreatitis, contributing to improved quality of life.展开更多
文摘目的:探讨外周血平均血小板体积/淋巴细胞计数(MPVLR)联合APACHE II评分对脓毒症患者预后的预测价值。方法:采用回顾性队列研究方法,选择该院2020年8月至2023年8月收治的符合脓毒症3.0诊断标准的患者。根据脓毒症患者的28 d预后情况分为生存组及死亡组。收集患者的临床资料及确诊脓毒症后24 h内血小板体积(MPV)、淋巴细胞(LYM)计数的最差值,并计算平均血小板体积/淋巴细胞计数(MPVLR)、APACHE II评分及SOFA评分。随后使用多因素Logistic回归分析,确定脓毒症患者预后的影响因素,再构建受试者工作特征曲线,评估各项指标对脓毒症患者预后的预测价值。结果:共纳入患者127例,生存组患者76例,死亡组患者51例。死亡组患者更易合并慢性阻塞性肺疾病,且平均血小板体积(MPV)、平均血小板体积/淋巴细胞计数(MPVLR)、APACHE II评分、SOFA评分、及年龄均高于生存组,且差异具有统计学意义(P Objective: To investigate the prognostic value of the mean platelet volume (MPV)-to-lymphocyte ratio (MPVLR) combined with the APACHE II score in predicting the outcomes of patients with sepsis. Methods: This retrospective study screened patients with sepsis who were hospitalized in our hospital, from August 2020 to August 2023 were included and categorized into the survival group and the non-survival group based on 28-day outcomes of sepsis patients. Clinical date and the worst of mean platelet volume (MPV), lymphocyte (LYM) count values within 24 hours of sepsis diagnosis were collected, MPVLR and APACHE II scores were calculated. Multifactorial logistic regression analysis was used to identify risk factors affecting the prognosis of sepsis patients, and then a subject operating characteristic curve (ROC) was constructed to assess the predictive value of each indicator on the prognosis of sepsis patients. Results: A total of 127 patients were included, with 76 in the survival group and 51 in the non-survival group. Patients in the non-survival group were more likely to have chronic obstructive pulmonary disease, and had significantly higher MPV, MPVLR, APACHE II scores, SOFA scores and age compared to the survival group (P < 0.05). In contrast, peripheral blood lymphocyte counts in the survival group were significantly higher than that in the non-survival group (P < 0.05). Multivariate logistic regression analysis showed that MPVLR and APACHE II scores were independent risk factors for 28-day mortality in sepsis patients (P < 0.05). Receiver operating characteristic curve (ROC) curve analysis showed that the area under the curve (AUC) values for MPVLR, APACHE II scores, and their combination were 0.840, 0.800, and 0.885, respectively. Notably, the MPVLR combined with the APACHE II score showed the best predictive value, with an AUC of 0.824. It demonstrated excellent predictive performance, achieving a sensitivity of 94.6% and a specificity of 82.4%. Conclusion: APACHE II scores and MPVLR are independent risk factors for 28-day mortality in sepsis patients, and their combined use provides higher predictive value.
文摘分析急性生理与慢性健康评分(APACHE-Ⅱ评分)、红细胞体积分布宽度(red cell volume distribution width,RDW)及氨基末端脑利钠肽前体(NT-proBNP)与脓毒症患者预后的相关性。选取72例脓毒症患者作为研究对象,患者的入院时间为2022年1月—2023年12月,按照存活与否将患者分为存活组(n=58)和病亡组(n=14),对比存活组与病亡组患者的APACHE-Ⅱ评分、RDW及NT-proBNP指标。结果显示,存活组与病亡组脓毒症患者的APACHE-Ⅱ评分、RDW及NT-proBNP差异显著,存活组脓毒症患者的APACHE-Ⅱ评分、RDW及NT-proBNP更优,差异有统计学意义(P<0.05)。BNP浓度越高,APACHE-Ⅱ评分越高,BNP浓度与APACHE-Ⅱ评分成正比。研究发现,APACHE-Ⅱ评分、RDW及NT-proB-NP与脓毒症患者的预后具有相关性。
文摘目的探讨APACHE-O评分系统(APACHE-II+肥胖指标评分)对急性重症胰腺炎的预测价值。方法2004年1月1日至2006年1月1日间急性胰腺炎患者142例,根据体重指数(body mass index,BMI)分组,把BMI≥26kg/m归为肥胖组,BMI<26kg/m归为非肥胖组。比较两组患者病情严重程度及并发症等发生情况。分别计算入院24h内APACHE-Ⅱ和APACHE-O评分在不同临界点对急性重症胰腺炎预测的敏感性、特异性、阳性预测值、阴性预测值和准确性,绘制APACHE-II和APACHE-O评分受试者工作曲线(receive-operating curves,ROC)。通过比较ROC的曲线下面积(area under the curve,AUC)来比较两评分系统的预测准确性。结果肥胖组中急性重症胰腺炎患者比例显著高于非肥胖组(P<0.05),肥胖组中胰腺坏死、胰腺假性囊肿及肺功能衰竭发生率显著高于非肥胖组(P<0.05)。取临界点为8时,APACHE-Ⅱ和APACHE-O评分对急性重症胰腺炎预测的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为78.9%,85.4%,45.5%,96.3%,84.5%和78.9%,82.1%,40.5%,96.2%,81.7%。APACHE-Ⅱ和APACHE-O评分的ROC的AUC分别为0.864和0.870,提示APACHE-O评分对重症胰腺炎预测价值稍高于APACHE-Ⅱ评分。结论肥胖型急性胰腺炎患者预后更差。与入院时A-PACHE-Ⅱ评分比较,APACHE-O评分对急性重症胰腺炎的预测价值略高于APACHE-II,为理想的急性重症胰腺炎预测系统。
文摘Objective: To explore the application effect of nursing interventions based on APACHE II scores in patients with severe pancreatitis and its impact on the recovery time of the gastrointestinal function. Methods: A total of 86 patients with severe pancreatitis treated in our hospital from March 2023 to March 2024 were selected. Using a random number table method, the patients were divided into a control group receiving conventional nursing care and a study group receiving nursing interventions based on APACHE II scores, with 43 patients in each group. The intervention effects of the two groups were compared. Results: The recovery time of gastrointestinal function in the study group was significantly shorter than that in the control group (P < 0.05). After the intervention, the quality of life scores in the study group was significantly higher than those in the control group (P < 0.05). The incidence of complications in the study group was significantly lower than in the control group (P < 0.05). Conclusion: Nursing interventions based on APACHE II scores can shorten gastrointestinal recovery time and reduce complications in patients with severe pancreatitis, contributing to improved quality of life.
