EICU患者APACHEⅡ评分及促炎因子水平与临床结局的相关性

目的 分析急诊重症监护室（emergency intensive care unit, EICU）患者急性生理和慢性健康状况评分（APACHEⅡ评分）及促炎因子与临床结局之间的关系。方法 随机收集2016—2017年EICU收治的103例住院患者，根据APACHE Ⅱ评分分为高危组和低危组。分别检测记录并比较两组患者TNF-α、IL-6、IL-8及死亡率，并分析APACHE Ⅱ评分与其他各指标之间的相关性。结果 高危组患者的TNF-α、 IL-6、IL-8均显著高于低危组(P＜0.05),且高危组死亡率与低危组比较，差异有统计学意义(P＜0.05)；APACHE Ⅱ评分与IL-6、IL-8、TNF-α、死亡率成正相关(P＜0.05)。结论 APACHE Ⅱ评分结合IL-6、IL-8、TNF-α能够有效地判断EICU患者的疾病危重程度及预测患者的临床结局。
Objective To examine the relationship of clinical outcomes with acute physiology and chronic health status (APACHE Ⅱ scores) and serum proinflammatory factor levels in acute intensive care unit (EICU) patients. Methods One hundred and three patients admitted in EICU from 2016 to 2017 were enrolled in the study. According to APACHE Ⅱ scores, patients were classified as high risk group (n=45) and low risk group (n=58). The serum levels of TNF-α, IL-6, IL-8 were measured, the incidence of death was documented in two groups. The correlation of clinical outcomes with APACHE Ⅱ scores, serum proinflammatory factor levels and other indicators was analyzed. Results The serum levels of TNF-α, IL-6 and IL-8 in the high-risk group were significantly higher than those in the low-risk group (P<0.05), and the incidence of death in the high-risk group was significantly higher than that in the low-risk group (P<0.05). APACHE Ⅱ scores was positively correlated with IL-6, IL-8, TNF-α and the case fatality rate (P<0.05). Conclusion APACHE Ⅱ scores combined with IL-6, IL-8, TNF-α can determine the severity of EICU patients and predict the clinical outcomes of patients