摘要
目的评价入院时急性生理与慢性健康评估Ⅱ(APACHEⅡ)评分在重症急性胰腺炎(SAP)发生深部真菌感染(DFI)中的判断价值。方法回顾性分析2006年1月至2011年6月期间我院收治的132例SAP患者的临床资料,采用受试者操作特征曲线(ROC)评价APACHEⅡ评分预测DFI的价值。结果 132例SAP患者中39例发生DFI(29.5%),其中白色念珠菌感染36例(92.3%),合并热带念珠菌2例(5.1%),合并近平滑仿珠菌1例(2.6%);单部位感染27例(69.2%),多部位感染12例(30.8%)。39例发生DFI患者入院时APACHEⅡ评分为(17.1±3.8)分,而93例未发生DFI患者入院时APACHEⅡ评分为(9.7±2.1)分,前者明显高于后者(t=14.316,P=0.000)。APACHEⅡ评分对SAP患者发生DFI预测的ROC曲线下面积为0.745(P=0.000),95%CI为0.641～0.849。当截断值为15分时,预测效能最佳,其特异度为0.81,灵敏度为0.72,约登指数为0.53。结论入院时APACHEⅡ评分能较好地预测SAP患者DFI的发生,尤其当APACHEⅡ评分大于15分时,高度提示发生DFI的可能,必要时可行预防性抗真菌治疗。
Objective To evaluate the predicted value of APACHEⅡ score at admission for deep fungal infection（DFI） in patients with severe acute pancreatitis（SAP）.Methods The clinical data of 132 patients with SAP from January 2006 to June 2011 in our hospital were analyzed retrospectively.The receiver operating characteristic curve（ROC） was used for evaluating the predicted value.Results Thirty-nine patients with SAP infected DFI（29.5%）,of which 36 patients（92.3%） infected with Candida albicans,2 patients（5.1%） with Candida tropicalis,1 patient（2.6%） with pearl bacteria.And,among these 39 patients,27 patients（69.2%） infected at single site,12 patients（30.8%） infected at multi-site.The APACHEⅡ score in 39 patients with DFI was higher than that of 93 patients without DFI（17.1±3.8 versus 9.7±2.1,t=14.316,P=0.000）.The ROC for APACHEⅡ score predicting DFI was 0.745（P=0.000）,95%CI was 0.641-0.849.When the cut off point was 15,it showed the best forecast performance,with specificity 0.81,sensitivity 0.72,Youden index 0.53.Conclusions The APACHEⅡ score at admission can preferably predict DFI in patients with SAP;when the APACHEⅡ score is greater than 15,it prompts highly possible of DFI,so preventive anti-fungal treatment may be necessary.
出处
《中国普外基础与临床杂志》
CAS
2012年第2期197-199,共3页
Chinese Journal of Bases and Clinics In General Surgery
关键词
胰腺炎
真菌感染
急性生理及慢性健康评估Ⅱ
受试者操作特征曲线
预测
Pancreatitis
Fungal infection
Acute physiology and chronic health evaluationⅡ
Receiver operating characteristic curve
Prediction
作者简介
段群欢（1974年-），男，湖南省永州市祁阳县人，本科副主任医师，主要从事肝、胆、胰腺、乳腺等方面的工作。【通讯作者】段群欢，E-mail：yx345812@163．com
