预测评分量表对卒中相关性肺炎的应用价值  

Application Value of Predictive Scoring Scale for Stroke-associated Pneumonia

作　　者：舒兆瑞[1] 王兵[1] 张克飞 SHU Zhao-rui;WANG Bing;ZHANG Ke-fei(Department of Neurology,Huai'an Hospital,Nanjing University of Traditional Chinese Medicine,Huai'an 223001,Jiangsu,China)

机构地区：[1]南京中医药大学附属淮安医院神经内科

出　　处：《医学信息》2020年第1期124-126,共3页Journal of Medical Information

基　　金：江苏省中医药局科技项目(编号：YB2015122)

摘　　要：目的分析多种卒中相关性肺炎危险因素预测评分表的特点及其临床应用价值。方法检索PubMed和CNKI中有关卒中相关性肺炎危险因素预测评分表的文献,包括针对SAP制定预测评分表的文献及应用现有卒中相关评分表预测SAP的文献,用诊断试验质量评价工具(QUADAS-2)对文献报道的预测评分量表进行危险因素评分,分析相关评分与卒中相关性肺炎诊断率的关系,评估相关预测评分的临床应用价值。结果共检索到238篇相关研究文献,针对SAP制定预测评分表的文献162篇,应用现有卒中相关评分表预测SAP的文献76篇,共涉及13种预测评分表,其中年龄和NIHSS评分几乎在所有预测评分表中都有出现。对6种评分表进行了内部验证,5种评分表进行了外部验证,A2DS2评分是目前最受认可的,其敏感性和特异性均高于其他预测评分表。结论临床预测模型在应用时简单易行,不同评分表之间的敏感性和特异性是相似的。目前预测评分表对卒中相关性肺炎有一定的应用价值,但缺乏相关大型研究评价这些评分表对临床决策和预后的影响,其实用性仍需更多的临床研究来验证。Objective To analyze the characteristics of multiple stroke-associated pneumonia risk factor prediction scores and their clinical application value.Methods Retrieve the relevant literature on the risk-related predictive scores for stroke-associated pneumonia in PubMed and CNKI,including the literature on the development of predictive scores for SAP and the literature on the use of existing stroke-related scores to predict SAP.The diagnostic test quality assessment tool(QUADAS-2)was used to evaluate the risk factor scores of the predictive score scales reported in the literature,and the relationship between the relevant scores and the diagnosis rate of stroke-associated pneumonia was analyzed to evaluate the clinical application value of the relevant predictive scores.Results A total of 238 related research literatures were retrieved,162 were used to develop predictive scores for SAP,and 76 were used to predict SAP using existing stroke-related scores.A total of 13 predictive scores were involved,including age and NIHSS scores in almost all all appear in the forecast score sheet.6 types of scoring tables were verified internally and 5 types of scoring tables were externally verified.The A2DS2 score is currently the most recognized,and its sensitivity and specificity are higher than other predictive score tables.Conclusion The clinical prediction model is simple and easy to apply,and the sensitivity and specificity are similar among different scoring tables.At present,the predictive scores have certain application value for stroke-related pneumonia,but there is a lack of large-scale studies to evaluate the impact of these scores on clinical decision-making and prognosis,and its practicality needs to be verified by more clinical studies.

关 键 词：卒中相关性肺炎 预测评分量表 危险因素 年龄 NIHSS评分 

分 类 号：R743.3[医药卫生—神经病学与精神病学]