【摘 要】 目的 验证急性生理及慢性健康评分II(APACHE II)判断重症急性肾衰竭(ARF)合并多器官功能障碍综合征的病情严重程度及预后的准确性。 方法 回顾性收集219例重症ARF的APACHE II评分，通过死亡组、存活组APACHE II评分的比较及评分与实际病死率的相关性，初步评价其评估重症ARF病情严重程度的可靠性;比较预计死亡人数与实际死亡人数，评价评分系统对预测病死率的价值。以受试者工作特性曲线(ROC)下面积表示其对个体预后的判断能力。 结果 APACHE II评分死亡组比存活组高(24.0±8.2vs17.6±6.9，P<0.001)，与重症ARF的实际病死率呈正相关(r=0.98，P<0.001)。实际与预计病死率比值1.83(P<0.001)。APACHE II评分系统的ROC下面积为0.774±0.046。 结论 APACHE II评分系统适用于判断重症ARF的病情严重程度及预测预后，但不能准确预测群体病死率，宜动态评分提高预测准确性。

    【关键词】 APACHE II评分;肾功能衰竭，急性;多器官功能障碍综合征;预后

    The predictive value of APACHE II score system in prognostic assessment for219patients with acute renal failure and multiple organ dysfunction syndrome WANG Xiaobing，XIAYejun，PAN Huaifu，et al.Department of

    Nephrology，People's Hospital of Jiangyan City，Jiangsu，Jiangyan 225500，China

    【Abstract】 Objective To investigate the value of acute physiology and chronic health evaluation II(APACHE II)in evaluating the severity and predict mortality of acute renal failure(ARF)combined with multiple or-gan dysfunction syndrome(MODS).Methods 219patients with ARF and MODS were retrospectively analyzed by APACHE II.The probability of death was calculated for every patient according to APACHE II score.By comparing APACHE II scores in actual motality of patients ......