目的:回顾性分析原始和校正后两种急性生理学和慢性健康评分Ⅱ(APACHEⅡ)模式对肝移植预后评估的准确性。方法:回顾性分析2004年3月至2005年8月上海交通大学医学院附属瑞金医院器官移植中心收治的74例肝移植病人的临床资料，应用原始和校正后APACHEⅡ模式计算并比较住院期间存活组（69例）和死亡组（5例）的两组病人的APACHEⅡ分值、死亡风险度、预期病死率。Hosmer-Lemeshow拟合优度、受试者操作特征曲线下面积分别评价两种APACHEⅡ模式的校准度、分辨度。结果:两组病人APACHEⅡ分值、死亡风险度差异有统计学意义。原始APACHEⅡ模式的预期病死率明显高于住院期间病人的实际病死率，校正后APACHEⅡ模式的校准度、分辨率好于前者。结论:原始APACHEⅡ模式对肝移植术后住院期间病死率预测过高，校正后APACHEⅡ模式对其预后的评估具有较好的准确性。

Objective:To study the accuracy of prognosis evaluation of patients underwent liver transplantation with two acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) models retrospectively. Methods:The clinical data of 74 cases of liver transplantation performed between March 2004 and August 2005 in Ruijin Hospital of Medical School of Shanghai Jiaotong University was analyzed retrospectively.All the cases were divided into survival group (69 cases) and died group (5 cases).The gender,age,etiology,preoperative childPugh classification and operative pattern were compared between two groups.APACHE Ⅱ score,risk of death,predicted hospital mortality calculated by original and modified APACHE Ⅱ models were compared also.The calibration and discrimination of two models were tested with HosmerLemeshow goodness-of-it and receiver operating characteristic curve statistic analysis respectively. Results:There was not magnificent difference in gender,age,etiology,preoperative childPugh classification and operative pattern.But score and risk of death had a significant difference between two groups.Original model overestimated hospital mortality.The calibration and discrimination of modified model were better than those of the original model. Conclusion:Original model overestimates the mortality.The modified model can provide an closely accurate prognosis evaluation of patients performed liver transplantation.