社区获得性肺炎两种病情评估方法的临床对比分析  

Comparison of two criteria for evaluating severity of community-acquired pneumonia in China

作　　者：李星晶[1] 张玉兰[1] 

机构地区：[1]上海市第一人民医院宝山分院呼吸科,200940

出　　处：《中华全科医师杂志》2007年第8期463-465,共3页Chinese Journal of General Practitioners

摘　　要：目的了解上海地区中心医院对社区获得性肺炎收治的现状,以2006年中华医学会制订的社区获得性肺炎诊断和治疗指南中的病情评估标准来评价住院患者病情严重度,为我国社区获得性肺炎指南的推广应用提供循证医学依据。方法以2005年1月至2006年9月我院呼吸科收治的137例社区获得性肺炎患者为对象,回顾性分析临床资料,对中国社区获得性肺炎诊疗指南中病情评估标准与肺炎严重度指数(PSI)分类的相关性进行比较研究;比较按中国社区获得性肺炎病情评估标准所分3组患者在住院时间、住院费用、抗生素静脉使用时间、危险因素数目、病死率等方面的差异。结果中国社区获得性肺炎病情评估标准与 PSI 分类有很好的相关性(r=0.577,P<0.01);按中国社区获得性肺炎病情评估标准,不符合住院标准组与符合住院标准组患者在住院时间、住院费用、抗生素静脉滴注时间等方面差异有统计学意义(P<0.05);不符合住院标准组与重症肺炎组在住院时间、住院费用、危险因素数目、病死率方而差异有统计学意义(P<0.01);符合住院标准组与重症肺炎组在住院费用、危险因素数目、病死率方面差异有统讣学意义(P<0.05)。结论中国社区获得性肺炎病情标准评估能准确判断患者病情严重度,应推广实施。PSI 分级同样适用于中国人。Objectives To understand current status of the admission and treatment for the patients with community-acquired pneumonia （ CAP ） in central hospitals of Shanghai area, and to evaluate the severity of patients admitted to the hospital with CAP by the criteria set in the Guidelines for Diagnosis and Treatment for CAP developed by the Chinese Medical Association in 2006 and provide evidence for its popularization and application throughout the country. Methods Medical records of 137 patients with CAP admitted to the hospital from January 1, 2005 to September 30, 2006 were retrospectively studied and analyzed with SPSS 10. 0 software. Chi-square test and ANOVA were used to evaluate the severity of the patients with CAP by the criteria set in the Guidelines and to correlate it with pneumonia severity index （PSI）. Statistical analysis was performed for the difference between length of hospitalization, cost, length of intravenous use of antibiotics, the number of risk factors, and fatality during hospitalization between three groups of patients categorized based on the severity criteria in the Guidelines. Results There existed a good relationship between the criteria for severity of CAP by the Guidelines and PSI, with a Pearson＇ s coefficient of correlation of 0. 577, P 〈 0. 01. There was statistically significant differences in length of hospitalization, cost, and length of intravenous use of antibiotics between the patients who met the criteria for admission and the patients who did not meet the criteria based on the Guidelines （P 〈 0. 05 ）. There also was a statistically significant difference in length of hospitalization, cost, the number of risk factors and fatality during hospitalization between the patients with severe CAP and the patients who did not meet the criteria base on the Guidehnes （P 〈0. 01 ）. As well as there was statistically significant difference in the number of risk factors, cost and fatality during hospitalization between the patient with severe CAP and the patients who m

关 键 词：社区获得性感染 肺炎 疾病严重程度指数 

分 类 号：R563.1[医药卫生—呼吸系统]