摘要
目的:探讨临床肺部感染评分(CPIS)的变化对卒中相关性肺炎(SAP)患者的预后评估作用。方法:对183例SAP患者进行分析,记录出现SAP前3天及发病后第1、3、5、7天的CPIS,根据预后将患者分为存活组和病死组,比较2组CPIS的差异。结果:所有患者发病后CPIS均比发病前明显升高(P<0.01);病死组发病后第1、3、5、7天与发病前3天的评分比较均明显升高(P<0.01);存活组发病后第1、3、5天与发病前3天的评分比较均明显升高,第7天则较第1天显著下降(P<0.01)。发病后第5天且CPIS>6分时,与存活患者相比病死率增高,其敏感性和特异性分别为91.3%和93.4%;CPIS与住院时间呈正相关关系(P<0.01);当接受充分治疗后,发病后第5天CPIS轻度下降,而在没有充分的抗感染治疗时变化不明显。结论:CPIS作为肺部感染程度的量化指标可以很好地预测SAP患者的预后。
Objective：To study the value of clinical pulmonary infection score（CPIS） changes on the prognosis for the patients with stroke-associated pneumonia（SAP）. Methods：The clinical data of 183 cases with SAP in the emergency ward were analyzed. CPIS was measured on 3 days before the onset of SAP and on 1 st, 3rd,5th, and 7th day after SAP. According to the prognosis of SAP, patients were divided into fatal group and survival group. The differences were compared between the two groups. Results A significant higher CPIS was found at the onset of SAP compared with before SAP（ P 〈 0.01 ）. CPIS was significantly increased in fatal group at the onset of SAP,as well as at 3rd,5th,and 7th day after onset compared with at 3 days before SAP（ P 〈 0.01 ）. CPIS was also increased in survivors at the onset of SAP,3rd and 5th day after onset compared with at 3 days before SAP,but decreased at 7th day after SAP onset compared with at 1st day after onset（ P 〈 0. O1 ）. In patients with CPIS 〉 6 at 5th day after SAP onset, the mortality was higher than those with CPIS 〈 6. The sensitivity and specificity of predicted mortality was 91.3% and 93.4% respectively. There was a positive correlation between CPIS and the length of hospital stay. Patients receiving adequate therapy showed a slight fall in CPIS 5 days after SAP onset, whereas there was no apparent change of CPIS on those with inadequate therapy. Conclusions： CPIS, as a quantitative indicator which reflecting the lung infection extent, can predict the prognosis of SAP patients effectively.
出处
《蚌埠医学院学报》
CAS
2014年第2期198-201,共4页
Journal of Bengbu Medical College
关键词
肺炎
脑卒中
临床肺部感染评分
pneumonia
stroke
clinical pulmonary infection score
