摘要
目的探讨慢性呼吸系统早期预警评分(CREWS)与BAP-65评分对普通住院病房慢性阻塞性肺疾病急性加重期(AECOPD)患者是否需要机械通气(MV)的预测效能。方法选择211例普通住院病房AECOPD患者,根据治疗过程中是否需要MV分为行MV者(观察组)和未行MV者(对照组)。于入院24 h内对211例纳入者进行CREWS、BAP-65评分,观察CREWS、BAP-65评分对AECOPD患者是否需要MV治疗的预测效能。结果观察组和对照组CREWS分别为(5.91±2.67)、(3.39±1.74)分,两组相比,P<0.05。观察组BAP-65评分等级为Ⅰ级7例、Ⅱ级19例、Ⅲ级15例、Ⅳ级4例、Ⅴ级0例,对照组分别为31、97、36、2、0例,两组相比,P<0.05。CREWS、BAP-65评分预测AECOPD患者是否需要MV的ROC曲线下面积(AUROC)分别为0.779与0.598。两种评分的AUROC分别与AUROC=0.5比较,P均<0.05。CREWS预测普通住院病房AECOPD患者行MV的AUROC明显高于BAP-65评分的AUROC,P<0.05。CREWS预测患者是否需要MV的最佳截断点为>5分,灵敏度为51.11%,特异度为86.75%;BAP-65评分预测患者是否需要MV的最佳截断点为>Ⅱ级,灵敏度为42.22%,特异度为77.11%。结论 CREWS、BAP-65评分均可用于预测普通住院病房AECOPD患者是否需要MV治疗,但CREWS对普通住院病房AECOPD患者是否需要MV的预测效能优于BAP-65评分。
Objective To investigate the validation of chronic respiratory early warning score（ CREWS） and BAP-65 in predicting the need for mechanical ventilation（ MV） in acute exacerbations of chronic obstructive pulmonary disease（ AECOPD） patients in normal ward. Methods A total of 211 patients with AECOPD in normal ward were selected. According to the need for MV they were divided into MV group（ observation group） and non-MV group（ control group）.CREWS and BAP-65 were scored in 211 patients within 24 hours of admission. We built the ROC curve to analyze the performance of CREWS and BAP-65. Results The scores of CREWS in the observation group and control group were（ 5. 91± 2. 67） and（ 3. 39 ± 1. 74） points,and the differences were statistically significant（ P 〈 0. 05）. The grade of BAP-65 in observation group： there were 7 cases of gradeⅠ,19 cases of gradeⅡ,15 cases of gradeⅢ,4 cases of gradeⅣ and 0 of gradeⅤ,while they were 31,97,36,2 and 0 cases,respectively in the control group（ P 〈 0. 05）. The AUROC of CREWS and BAP-65 that predicted MV were 0. 779 and 0. 598,respectively,and the differences were statistically significant（ P 〈 0. 05）. AUROC of CREWS was significantly higher than that of BAP-65 in predicting the need for MV in AECOPD patients in normal ward（ P 〈 0. 05）. The cut-off points of CREWS were 〉 5,the sensitivity was 51. 11%,and the specificity was 86. 75%. The cut-off points of BAP-65 were 〉 Ⅱ grade,the sensitivity was 42. 22%,and the specificity was 77. 11%. Conclusion Both CREWS and BAP-65 can be used to predict the need for MV of AECOPD patients in normal ward,but the performance of CREWS is more accurate and suitable than that of BAP-65.
作者
黄文婷
崔妙玲
蒋云
王自秀
陆汪洋
柯斓
HUANG Wenting CUI Miaoling JIANG Yun WANG Zixiu LU Wangyang KE Lan(The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China)
出处
《山东医药》
CAS
北大核心
2017年第7期20-22,共3页
Shandong Medical Journal
基金
广西医疗卫生适宜技术开发与推广应用课题(S201665)
广西急诊与医学救援人才小高地开放课题(GXJZ201427)
广西医药卫生计划资助项目(Z2015513)
