PIRO评分对急诊室社区获得性肺炎无创正压通气治疗失败的预测意义  

Predictive value of PIRO score for the non-invasive positive ventilation failure in emergency department patients with community acquired pneumonia

作　　者：朱永城[1] 江慧琳[1] 陈晓辉[1] 莫均荣[1] 伍卓文 冯雪珍[1] 林珮仪[1] Zhu Yong-cheng;Jiang Hui-lin;Chen Xiao-hui;Mo Jun-rong;Wu Zhuo-wen;Feng Xue-zhen;Lin Pei-Yi(Department of Emergency,the Second Affiliated Hospitalof Guangzhou Medical University,Guangzhou 510260,China)

机构地区：[1]广州医科大学附属第二医院急诊科,广东广州510260

出　　处：《中国急救医学》2019年第6期578-582,共5页Chinese Journal of Critical Care Medicine

基　　金：广东省科技计划项目(2014B02012013);广州市医学重点学科建设项目(2017-2019年).

摘　　要：目的探讨PIRO评分对急诊室社区获得性肺炎(CAP)患者无创正压通气(NPPV)治疗失败的预测价值。方法对122例行NPPV的急诊室CAP患者进行回顾性分析,分别计算PIRO、SMART-COP、CURB-65和IDSA/ATS次要标准的评分,根据NPPV治疗的结局,使用受试者工作特征曲线(ROC曲线),计算四种评分的曲线下面积(AUC),PIRO评分与SMART-COP、CURB-65和IDSA/ATS次要标准评分之间的AUC进行比较。结果 PIRO、SMART-COP、CURB-65和IDSA/ATS次要标准四种评分在NPPV治疗成功组和NPPV治疗失败组比较差异有统计学意义(P<0.01),其预测CAP患者NPPV治疗失败的AUC分别为0.804、0.746、0.639和0.762。PIRO评分与SMART-COP、IDSA/ATS评分的 AUC比较差异无统计学意义(P>0.05),PIRO评分与CURB-65评分的AUC比较差异有统计学意义(0.804 vs.0.638,P<0.05)。结论 PIRO评分对急诊室CAP 患者NPPV治疗失败有较好的预测价值,PIRO评分比CURB-65评分更具有优势。Objective To evaluate the predictive value of the predisposition insult response and organ failure (PIRO) scoring system for the non-invasive positive ventilation failure in emergency department patients with community acquired pneumonia (CAP).Methods A total of 122 patients with community-acquired pneumonia treated by NPPV in the emergency department were retrospectively analyzed.The PIRO,SMART-COP,CURB-65 and the minor criteria for severe CAP proposed by IDSA/ATS were calculated and compared between non-invasive positive ventilation success group and non-invasive ventilation failure group.The area under the receiver operating characteristic (ROC) curve was used to analyze the predictive value of the indicators above.The AUC of PIRO,SMART-COP,CURB-65 and IDSA/ATS score was analyzed by Z test.Results There were significant differences in PIRO,SMART-COP,CURB-65 and the minor criteria of IDSA/ATS between non-invasive positive ventilation success group and non-invasive positive ventilation failure group (P <0.05).The AUC of PIRO,SMART-COP,CURB-65 and the minor criteria of IDSA/ATS score for predicting mechanical ventilation were 0.804,0.746,0.639 and 0.762,respectively.There was no significant difference between PIRO and SMART-COP,as well the IDSA/ATS minor criteria (P > 0.05).But The AUC indicated that PIRO had better predictive values than CURB-65 (0.804 vs.0.638 ,P V 0.05).Conclusion Comparison of PIRO,SMART-COP,CURB-65 and IDSA/ATS Scores,PIRO score has predictive values for the non-invasive positive ventilation failure in the patients due to CAP in the emergency department.PIRO score has better predictive values than the CURB-65 score.

关 键 词：社区获得性肺炎(CAP) 无创正压通气(NPPV) PIRO评分 SMART-COP评分 CURB-65评分 IDSA/ATS次要标准评分 

分 类 号：R563.1[医药卫生—呼吸系统]