【作者】 王瑜；

【导师】 蒙健军；

【作者基本信息】 广西医科大学 ， 急诊医学， 2012， 硕士

【摘要】 目的：探讨血清胆碱酯酶(CHE)和急性生理学与慢性健康状况评分(APACHEⅢ评分)在急诊危重症监护室(EICU)患者的病情危重程度和预后评估的意义。方法：对EICU98例患者进行血清CHE浓度测定,并进行APACHEⅢ评分。按照APACHEⅢ评分将患者分为各个计分段,比较各计分段之间病死率的差异性。以APACHEⅢ评分60分为界线,将患者分为两组比较两组之间的病死率。将患者按预后分为存活组与死亡组进行组内比较,分析血清CHE浓度变化与APACHEⅢ评分的变化情况。分析患者血清CHE浓度和APACHEⅢ评分与病情及预后的关系。结果：APACHEⅢ评分以每30分作一个计分段,各计分段之间的病死率均有差异(P<0.05)。以60分为界线,APACHEⅢ评分(>60分)组的病死率明显高于APACHEⅢ评分(0-60分)组。死亡组的血清CHE浓度明显低于存活组(P<0.01),APACHEⅢ评分明显高于存活组(P<0.01)。血清CHE浓度与APACHEⅢ评分呈负相关(r=一0.983,P=0.003)。随着APACHEⅢ评分升高,血清CHE浓度降低,且病死率上升。结论：EICU患者血清CHE浓度和APACHEⅢ评分呈负相关。APACHEⅢ评分得分为60分可以作为一个较好地划分患者病情危重程度的分界线。测定血清CHE浓度和进行APACHEⅢ评分可作为EICU中患者病情危重程度和预后评估有意义的两项指标。更多还原

【Abstract】 Objective:To explore the relationship between cholinesterase in blood and acute physiology and chronic health evaluation III(APACHEⅢ) scores,evalua-tion of disease severity and prognosis of patients admitted to Emergency Intensive Care Unit (EICU).Methods:The APACHE Ⅲ scores of the patients of EICU were assessed, and the CHE concentrations were determinded in98patients. Patients were divided into various meter segmented according to the APACHEⅢscores. Compare the difference of fatality rate of each scoring segment. By the boundary of APACHEⅢscores score60points, all patients were divided into two group. Compare these group’s mortality rate. According to their prognosis, all patients were divided into two groups:survival group and death group, and the relationship between APACHE Ⅲ scores and the CHE concentration,prognosis were analyzed. Analysis of the relationship bet-ween changes in serum CHE, APACHE Ⅲ scores and the condition pro-gnosis.Results:The APACHE Ⅲ scores were taken every30points as a scoring seg ment. The fatality rate of the every group have no difference (P>0.05).APACHE Ⅲ scores60is divided into the boundaries. APACHE Ⅲ s-core (>60points) group, mortality was significantly higher than to the APACHE Ⅲ scores (0to60points) group (P<0.05). Death group serum CHE concentration was significantly lower in the survival group (P<0.01), APACHE Ⅲ scores was significantly higher in the survival group (P <0.01). Serum concentration of CHE and APACHE Ⅲ scores negatively correlated (r=0.983, P=0.003). With the APACHE Ⅲ scores increased, the concentration of CHE became lower, while mortality rate were raised (P<0.01)Conclusion:Serum CHE concentration and APACHE Ⅲ scores of EICU patients were negatively related. The score of APACHE III scores of60points as a better division of the severity of illness in patients with the dividing line. Determination of serum concentration of CHE and APACHE Ⅲscores c-an be used as EICU in patients with disease severity and prognosis asses- sment of meaningful two indicators.更多还原