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目的 探讨整合床旁血浆乳酸的序贯性器官功能衰竭评分(quick sequential organ failure assessment, qSOFA)用于急诊科快速评估严重脓毒症患者预后时的应用价值.方法 回顾性分析2016年4月-12月四川大学华西医院急诊科收治的严重脓毒症患者中资料齐全的821例患者临床数据,其中男性528例、女性293例,年龄(57.5±17.8)岁.计算每个患者的qSOFA评分,联合qSOFA和乳酸的LAC-qSOFA评分以及SOFA评分,通过ROC曲线分别比较三种方法评价严重脓毒症患者28 d死亡率和是否入住ICU两个指标,分别计算灵敏度、特异度等指标.结果 qSOFA评分,LAC-qSOFA评分以及SOFA评分用于急诊室严重脓毒症患者28 d死亡率评估时的ROC曲线下面积分别为0.669,0.690和0.772;LAC-qSOFA评分与另外两个评分的的ROC曲线下面积差异均有统计学意义(P<0.05).结论 LAC-qSOFA评分用于严重脓毒症患者28 d死亡率评估时准确度高于qSOFA评分,虽其准确性仍低于SOFA评分,但较SOFA评分简易、快速.“,”Objective To evaluate the combination of qSOFA and bedside plasma lactate for prognosis in patients with severe sepsis.Methods 821 cases were recorded of patients whom were diagnosed with severe sepsis in the Emergency Department of West China Hospital enrolled between April 1st and December 31st of 2016.Of these cases,528 were male and 293 were female.The mean age was 57.5±17.8 years.All cases include calculations of qSOFA,LAC-qSOFA which combines both qSOFA and bedside plasma lactate as well as the SOFA score.The receiver operator curve(ROC) compared the three methods(qSOFA,LAC-qSOFA,and SOFA).28-day mortality and whether to stay in the ICU were two indicators used to evaluate patients with severe sepsis.Results For sepsis patients,the areas under the ROC curve for qSOFA, LAC-qSOFA, and SOFA score were 0.669,0.690 and 0.772, respectively. There was a significant difference between LAC-qSOFA when compared individually to both qSOFA and SOFA (P<0.05). Conclusion LAC-qSOFA is a simple and quick method to provide a more specific prognosis in patients with severe sepsis.