[1]张苓莉,文 丹,王 瑶,等.EHSS评分系统对劳力性热射病患者预后的评估价值[J].医学信息,2023,36(14):87-90.[doi:10.3969/j.issn.1006-1959.2023.14.016]
 ZHANG Ling-li,WEN Dan,WANG Yao,et al.Prognostic Value of EHSS Scoring System in Patients with Exertional Heat Stroke[J].Journal of Medical Information,2023,36(14):87-90.[doi:10.3969/j.issn.1006-1959.2023.14.016]
点击复制

EHSS评分系统对劳力性热射病患者预后的评估价值()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年14期
页码:
87-90
栏目:
临床信息学
出版日期:
2023-07-15

文章信息/Info

Title:
Prognostic Value of EHSS Scoring System in Patients with Exertional Heat Stroke
文章编号:
1006-1959(2023)14-0087-04
作者:
张苓莉文 丹王 瑶
(电子科技大学医学院附属绵阳医院/绵阳市中心医院重症医学科,四川 绵阳 621000)
Author(s):
ZHANG Ling-liWEN DanWANG Yaoet al.
(Intensive Care Unit of Mianyang Hospital Affiliated to Medical College of University of Electronic Science and Technology of China/Mianyang Central Hospital,Mianyang 621000,Sichuan,China)
关键词:
EHSS评分热射病劳力性热射病预后
Keywords:
EHSS scoring systemHeat strokeExertional heat strokePrognosis
分类号:
R594.1
DOI:
10.3969/j.issn.1006-1959.2023.14.016
文献标志码:
A
摘要:
目的 评估劳力性热射病评分(EHSS)系统对劳力性热射病(EHS)患者预后的评估价值。方法 选取2020年6月-2022年8月绵阳市中心医院重症医学科收治的89例劳力型热射病患者为研究对象,按预后情况分为存活组(62例)及死亡组(27例)。采集患者入院24 h内的 EHSS评分系统参数,包括体温、肝肾功能、凝血功能、急性生理学和慢性健康状况评分Ⅱ(APACHEⅡ)和序贯器官衰竭评分(SOFA),绘制受试者工作特征(ROC)曲线,分析上述3项评分对患者预后的评估价值。结果 两组性别、年龄、核心体温比较,差异无统计学意义(P>0.05);单因素分析显示,存活组与死亡组入院24 h内EHSS评分系统各参数比较,差异均有统计学意义(P<0.05);存活组EHSS、APACHEⅡ、SOFA 评分低于死亡组,差异有统计学意义(P<0.05);ROC曲线显示,EHSS评分曲线下面积(AUC)为0.997,大于APACHEⅡ评分(0.911)和SOFA评分(0.881),其诊断效率高于其他2种评分,EHSS评分评估患者预后的敏感性和特异性均高于APACHEⅡ和SOFA 评分,差异有统计学意义(P<0.05)。结论 EHSS、APACHEⅡ和SOFA评分均能较好的预测劳力性热射病患者的预后,其中EHSS评分更为准确。
Abstract:
Objective To evaluate the prognostic value of the exertional heat stroke score (EHSS) system in patients with exertional heat stroke (EHS).Methods A total of 89 patients with exertional heat stroke admitted to the Intensive Care Unit of Mianyang Central Hospital from June 2020 to August 2022 were selected as the research objects. According to the prognosis, they were divided into survival group (62 patients) and death group (27 patients). The parameters of EHSS scoring system within 24 h after admission were collected, including body temperature, liver and kidney function, coagulation function, acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score and sequential organ failure assessment (SOFA) score. The receiver operating characteristic (ROC) curve was drawn to analyze the prognostic value of the above three scores.Results There was no significant difference in gender, age and core body temperature between the two groups (P>0.05). Univariate analysis showed that there were significant differences in the parameters of EHSS scoring system between the survival group and the death group within 24 hours after admission (P<0.05). The scores of EHSS, APACHEⅡ and SOFA in the survival group were lower than those in the death group, and the differences were statistically significant (P<0.05). ROC curve showed that the area under the curve (AUC) of EHSS score was 0.997, which was higher than that of APACHEⅡ score (0.911) and SOFA score (0.881), and its diagnostic efficiency was higher than that of the other two scores. The sensitivity and specificity of EHSS score in evaluating the prognosis of patients were higher than those of APACHE Ⅱ score and SOFA score, and the differences were statistically significant (P<0.05).Conclusion EHSS, APACHEⅡ and SOFA scores can better predict the prognosis of patients with exertional heat stroke, and the EHSS scoring system is more accurate.

参考文献/References:

[1]Xia DM,Wang XR,Zhou PY,et al.Research progress of heat stroke during 1989-2019: a bibliometric analysis[J].Mil Med Res,2021,8(1):5. [2]全军热射病防治专家组,热射病急诊诊断与治疗专家共识组.热射病急诊诊断与治疗专家共识(2021版)[J].中华急诊医学杂志,2021,30(11):1290-1299. [3]胡志航,付文佩,纪小奇,等.早期高压氧治疗热射病中枢性损害的疗效分析[J].中国基层医药,2021,28(2):218-222. [4]程丽,刘德林,王敏娜,等.劳力性热射病发生急性肾损伤的危险因素分析[J].中华劳动卫生职业病杂志,2021,39(1):29-32.[5]Hifumi T,Kondo Y,Shimizu K,et al.Heat stroke[J].J Intensive Care,2018,22(6):30.[6]Laitano O,Leon LR,Roberts WO,et al.Controversies in exertional heat stroke diagnosis, prevention, and treatment[J].J Appl Physiol,2019,127(5):1338-1348. [7]程丽,刘德林,王敏娜,等.不同的危重症评分系统对于热射病患者预后的预测价值[J].中华劳动卫生职业病杂志,2020,38(6):456-459.[8]Knapik JJ,Epstein Y.Exertional Heat Stroke: Pathophysiology, Epidemiology, Diagnosis, Treatment, and Prevention[J].J Spec Oper Med,2019,19(2):108-116. [9]He S,Li R,Peng Y,et al.ACSL4 contributes to ferroptosis-mediated rhabdomyolysis in exertional heat stroke[J].J Cachexia Sarcopenia Muscle,2022,13(3):1717-1730. [10]Yang MM,Wang L,Zhang Y,et al.Establishment and effectiveness evaluation of a scoring system for exertional heat stroke by retrospective analysis[J].Mil Med Res,2020,7(1):40. [11]李海玲,陈玉东,张海生.热射病防治技术手册[M].北京:人民军医出版社,2015.[12]Seoane LA,Espinoza J,Burgos L,et al.Valor pronóstico del sistema de calificación APACHE Ⅱenelpostoperatorio de cirugíacardíaca Prognostic value of APACHE Ⅱ score in postoperative of cardiac surgery[J].Arch Cardiol Mex,2020,90(4):398-405. [13]Krebs ED,Hassinger TE,Guidry CA,et al.Non-utility of sepsis scores for identifying infection in surgical intensive care unit patients[J].Am J Surg,2019,218(2):243-247. [14]Wu M,Wang C,Liu Z,et al.Sequential Organ Failure Assessment Score for Prediction of Mortality of Patients With Rhabdomyolysis Following Exertional Heatstroke:A Longitudinal Cohort Study in Southern China[J].Front Med (Lausanne),2021,8:724319.[15]窦建林,宋景春,余甜,等.不同核心温度下劳力性热射病大鼠凝血功能障碍特征研究[J].创伤与急危重病医学,2022,10(2):92-96. [16]章洪院,李海山.三种评分方法对热射病临床预后的预测价值[J].中华劳动卫生职业病杂志,2020,38(5):358-361.[17]钟林翠,宋景春,高燕,等.中暑患者发生热射病危险因素分析[J].创伤与急危重病医学,2022,10(2):97-99,104. [18]杨乾坤,陈通,裴祎,等.热射病合并横纹肌溶解综合征及前臂骨筋膜室综合征1例报道[J].中国医科大学学报,2020,49(1):91-93. [19]Laitano O,Oki K,Leon LR.The Role of Skeletal Muscles in Exertional Heat Stroke Pathophysiology[J].Int J Sports Med,2021,42(8):673-681. [20]李庆华,孙荣青,吕宏迪,等.不同起始时间亚低温治疗对劳力性热射病患者各器官的保护作用[J].中华危重病急救医学,2018,30(4):365-368.

更新日期/Last Update: 1900-01-01