| 摘要: |
| 目的：通过对小儿危重病例评分来评估入院时重症手足口病患儿病情严重程度，并分析该评分系统对预后（并发症和结局）的预测能力。方法：选取2010年1月至2014年6月入住我院重症监护室的符合重症手足口诊断标准的患儿123名。收集PCIS评分系统的相关生理参数及结局资料，通过受试者工作特征曲线（ROC）下的面积来评估评分系统对并发症、结局和后遗症的分辨力。结果：通过PCIS来评价重症手足口病患儿病情，存活组患儿评分的中位数明显高于死亡组患儿（Z=-8.82，P=0.00）。病情评估发现危重型病例仅有10（8.13%）名。小儿危重病例分辨是否发生并发症、死亡和后遗症的ROC曲线下面积（AUC）和95%可信区间分别是0.78（0.70，0.88）、0.86（0.78，0.95）和0.84（0.77，0.89）。结论：小儿危重病例评分不能充分评价重症手足口病病情的严重程度，需要探索更能反映手足口病病情严重程度的指标。 |
| 关键词: 小儿危重病例评分 病情严重程度 重症手足口病 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2016.02.003 |
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| 基金项目: |
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| Evaluating the Severity Degree and Predicting the Progression in Severe Hand, Foot and Mouth disease by PCIS |
| Jiang Haoming, Gu Chengping |
| (Maternal and Children Health Care Hospital of Zhoushan, Zhejiang Province Zhoushan 316000, China) |
| Abstract: |
| Objective: The study was to compare the performance of pediatric critically illness score (PCIS) in predicting the progression of severe hand foot and mouth disease. Method：123 severe HFMD pediatric patients were recruited in the study from 1th Jan 2010 to 31th June 2014. Information on age, sex, diagnosis, length of stay in PICU, the outcome and the variables required to calculate PCIS were collected. The area under receiver operating characteristic plot (Az ROC) was to assess discrimination the complications and outcome in severe HFMD. Result：The median of PCIS for death patients was lower than for survived patients (Z=-8.82，P=0.00). The area under the receiver-operating characteristics (ROC) curve (95% confidence interval) was 0.78(0.70, 0.88) for PCIS to discriminate pulmonary edema or pulmonary hemorrhage patients. The area under the receiver-operating characteristics (ROC) curve (95% confidence interval) was 0.86(0.78, 0.95) for PCIS to discriminate death patients. The area under the receiver-operating characteristics (ROC) curve (95% confidence interval) was 0.84(0.77, 0.89) for PCIS to discriminate sequel period patient. Conclusion：Pediatric critical illness score cannot adequately evaluate the severity of HFMD. Therefore, some physiological parameters were included in order to more objectively evaluate the severity of HFMD. |
| Key words: Pediatric Clinical Illness Score The Severity of Disease Severe Hand, Foot and Mouth Disease |
