关键词: 危重病, 血脂, 代谢, 急性生理学及慢性健康状况评分Ⅱ

Abstract: Objective To study the relationship between acute physiology and chronic health evaluation Ⅱ score(APACHE Ⅱ) and serum lipid level, and explore the ability to patients in emergency intensive care on prognosis of 28-days mortality. Methods Totally 1992 critically ill patients were selected. These patients were admitted to the urgency room in emergency department, Beijing Chaoyang Hospital, between October 2009 and October 2010 Laboratory examinations, including blood routine test, blood glucose, arterial blood gas analysis, hepatic and renal function, and lipid level, were performed. Every patients' APACHE Ⅱ score was calculated with the worse data in the beginning 24 hours. According to the 28-days mortality, all patients were divided into two groups: survival group and dead group. Results The serum TC, LDL and HDL level in dead group were significantly lower, and serum TG, TG/HDL and APACHE Ⅱ score were significantly higher than those in survival group. In critically ill patients, the APACHE Ⅱ score was positively correlated with TG and TG/HDL, and was negatively with TC, LDL and HDL. We performed the Binary logistic regression analysis and found that plasma HDL and APACHE Ⅱ were independent risk factors, which had important effect on clinical prognosis. We used receiver-operating-characteristic(ROC) analysis in both of them for the prognosis. Conclusion There were low serum lipid levels in the critically ill patients. There was correlation between APACHE Ⅱ and serum lipid level. APACHE Ⅱ score combined with serum lipid level can better predict the 28-days mortality in critically ill patients.

Key words: critical illness, blood lipid, metabolism, acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)