《社区获得性肺炎诊疗指南》与Fine危险分层在社区获得性肺炎中的应用价值  

Application Values of Community-acquired Pneumonia Diagnosis and Treatment Guidelines and Fine Risk Stratification in Community-acquired Pneumonia

作　　者：袁蓓[1,2] 杜娟[1] 唐凤婕 杜丹[1] 陈丽娜[1] 

机构地区：[1]贵阳医学院,贵州贵阳550004 [2]贵阳医学院附院呼吸内科,贵州贵阳550004

出　　处：《贵阳医学院学报》2015年第5期493-496,共4页Journal of Guiyang Medical College

基　　金：贵州省优秀科技教育人才省长专项资金项目[黔省专合字(2008)90号]

摘　　要：目的:评价《社区获得性肺炎诊断和治疗指南》(简称《指南》)与Fine危险分层在评价社区获得性肺炎(CAP)中的应用价值。方法:以贵阳地区5所医院呼吸内科病房收治的196名成人CAP患者为研究对象,按照Fine危险分层分为I^V级,按照《指南》标准分为《指南》1组、2组和3组,比较Fine危险分层重症肺炎发生率和死亡率,分析按照两种方法分组的各组患者的病情程度的相关性,同时观察《指南》各组患者住院及输液时间,治疗费用及危险因素,同时还比较《指南》1组和2组抗菌素使用情况。结果:随Fine危险分层的级别升高,重症肺炎的发生率及病死率升高(P<0.05),Fine危险分层与《指南》分组具有较强的相关性(r=0.623,P<0.05);《指南》1组CAP患者的住院及输液时间短于《指南》2组和3组,住院费用及危险因素项目少于《指南》2组和3组,《指南》1组抗生素联合治疗比例低于《指南》2组,静脉用抗生素种类也存在差异(P<0.05)。结论:《指南》与Fine危险分层在评估CAP时具有相似的临床意义。Objective： To evaluate the application value of community-acquired pneumonia（ CAP）diagnosis and treatment guidelines and Fine risk stratification in CAP. Methods： A total of 196 adult CAP patients who were admitted to respiratory medicine wards of five hospitals in Guiyang region were selected for retrospective analysis. Patients were grouped based on Fine risk stratification（ class I ～ V）and the Guidelines（ group1,group 2 and group 3） respectively. The incidence of severe pneumonia and mortality of different classes of Fine risk stratification were compared. The correlation of Fine risk stratification and the guidelines in disease severity evaluation was analyzed. Length of stay,infusion time,treatment cost and risk factors of groups 1,2 and 3 were compared,and use of antibiotics were compared between group 1 and group 2. Results： According to Fine risk stratification,the higher the risk level of CAP,the higher the mortality（ P〈0. 05）. Fine risk stratification was strongly correlated with guidelines（ r = 0. 623,P〈0. 05）. According to Guidelines grouping,patients in ＂ Guidelines＂ group 1 had shorter hospital stay and infusion time,less treatment cost and risk factors compared with those in ＂ Guidelines＂ group 2 and group 3. Patients in ＂ Guidelines＂ group 2 would be treated with more types of antibiotics as compared with those in ＂ Guidelines＂ group 1,there were differences in intravenous antibiotic types（ P〈0. 05）. Conclusions： Guidelines and Fine risk stratification have similar effects on the classification of CAP patients.

关 键 词：社区获得性肺炎 Fine危险分层 诊断 抗生素 治疗学 

分 类 号：R563.1[医药卫生—呼吸系统]