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| 基于红细胞分布宽度的肺炎临床评分对ICU社区获得性肺炎预后的判断价值 |
| Value of RPCS score in assessing prognosis of patients with communityacquired pneumonia |
| 投稿时间：2021-05-17 |
| DOI：10.3969/j.issn.1000-0399.2022.01.007 |
| 中文关键词: 社区获得性肺炎 基于红细胞分布宽度的肺炎临床评分 CURB-65评分 肺炎严重指数评分 |
| 英文关键词: Community acquired pneumonia RDW based pneumonia clinical score CURB-65 Pneumonia severity index score |
| 基金项目:江苏省自然科学基金（项目编号：BK20200367），黄山市第五批市"特支计划"创新领军人才科研基金项目（项目编号：黄人才办[2020]3号） |
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| 中文摘要: |
| 目的 探讨基于红细胞分布宽度的肺炎临床评分（RPCS）对收住重症监护病房（ICU）的社区获得性肺炎（CAP）预后的判断价值，并与CURB-65评分、PSI评分比较。方法 回顾性分析2017年10月至2019年8月在黄山市人民医院ICU住院的CAP患者的临床资料。根据患者在ICU的转归分为死亡组（n=30例）与好转组（n=74），比较两组患者3种评分和其他指标的差异。用受试者工作特征曲线下面积评价3种评分对CAP入住ICU预后的判断力。结果 104例患者被纳入最后的分析，好转组74例，死亡组30例，病死率为28.85%。CURB-65评分、PSI评分和RPCS评分的ROC曲线下面积分别是0.652（95% CI：0.533~0.770，P=0.016）、0.798（95% CI：0.709~0.886，P<0.001）、0.858（95% CI：0.788~0.928，P<0.001）。PSI和RPCS的ROC曲线下面积均大于CURB-65评分，差异有统计学意义（Z=1.981，P=0.048；Z=3.167，P=0.002），RPCS评分和PSI评分的ROC曲线下面积比较，差异无统计学意义（Z=1.062，P=0.288）。结论 RPCS对入住ICU的CAP患者预后有较好的判断价值，与PSI评分相当，优于CURB-65评分，且评分简便，值得在临床中推广使用。 |
| 英文摘要: |
| Objective To evaluate the prognostic effects of RDW based pneumonia clinical score in patients admitted in ICU with community acquired pneumonia, compared with CURB-65 score and pneumonia severity index(PSI) score.Methods The clinical characteristics of patients admitted to People's Hospital of Huangshan from October 2017 to August 2019 with a diagnosis of community acquired pneumonia were retrospectively analyzed. The patients were assigned to the death group(n=30) and the survival group(n=74). Three different scores were compared with other variables. The areas under the receiver operating characteristic curve were applied to evaluate three scores prognosis values in community-acquired pneumonia of ICU.Results Among 104 patients, 30 patients were finally assigned to the death group and 74 patients to the survival group. The mortality was 28.85%. The area under the ROC of CURB-65 score, PSI score and RPCS score was respectively 0.652 (95%CI:0.533~0.770, P=0.016), 0.798 (95%CI:0.709~0.886, P<0.001), 0.858 (95%CI:0.788~0.928, P<0.001). The area under the ROC of PSI score and RPCS score was higher than that of CURB-65 score (Z=1.981, P=0.048;Z=3.167, P=0.002). The area under the ROC curve of RPCS score and PSI score showed no statistically significant difference (Z=1.062, P=0.288). Conclusion RPCS score has greater prognostic value in patients with community acquired pneumonia, which is equal to PSI score and better than CURB-65 score.The score is simple and worthy of clinical popularization and application. |
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