【摘要】 目的　采用感染相关的器官衰竭评分系统 (SOFA)描述多器官功能障碍综合征 (MODS)的临床特点。方法　回顾了 5家医院的加强医疗病房 (ICU) 1990至 1996年间收治的 36 6例MODS患者 ,并进行SOFA评分。结果　最高SOFA评分、SOFA评分差值以及入ICU时的SOFA评分与患者的住院病死率呈较好的相关关系 ,ROC曲线下的面积分别为 0 819,0 75 0和 0 6 16。没有器官衰竭的患者SOFA评分为 3 7± 1 2 ,病死率 2 1 7% ,6个器官衰竭的患者SOFA评分为 2 0 2± 1 4,病死率77 8%。呼吸系统达到最高评分的时间最短 (1 41d) ,循环系统所需时间最长 (4 89d)。Logistic回归模型显示 ,中枢神经系统评分对预后的影响最大 (OR 1 75 ) ,之后是肾脏 (OR 1 42 ) ,循环系统 (OR1 38) ,凝血 (OR 1 34)和呼吸系统 (OR 1 17)。肝脏对患者的预后没有影响 (OR 0 99)。结论　最高SOFA评分和SOFA评分差值可以较好地反映患者在ICU住院期间MODS的发生及预后情况。更多还原

【Abstract】 Objective To describe the clinical properties of multiple organ dysfunction syndromB (MODS) with sepsis related organ failure assessment (SOFA). Methods A total of 366 MODS patients admitted to the 5 participating ICUs from 1990 to 1996 were included in this study. SOFA score and demographic data were retrospectively evaluated. Results Total maximum SOFA score, delta SOFA and admission total SOFA score exhibited a good correlation with hospital mortality rate, with the area under the ROC curve of 0 819, 0 750 and 0 616, respectively. The SOFA score for patients without organ failure was 3 7±1 2, with a mortality rate of 21 7%, and the SOFA score for patients with failure of all 6 organs was 20 2±1 4, with a mortality rate of 77 8%. A maximum score was firstly reached for respiratory system (1 41 days after admission), and last for cardiovascular system (4 89 days). Logistic regression model revealed that the central nervous system was associated with the highest relative contribution (odds ratio 1 75) to hospital outcome, followed by renal ( OR 1 42), cardiovascular ( OR 1 38), coagulation ( OR 1 34) and respiratory ( OR 1 17) systems . No independent contribution was found for the hepatic score ( OR 0 99). Conclusion Total maximum SOFA score and delta SOFA can be used to quantify the progress of MODS during ICU stay.更多还原