常见评分系统对社区获得性肺炎预后的效果评价

Effect evaluation of common scoring system for prognosis of community-acquired pneumonia

目的探讨CURB-65评分、A-DROP评分、q-SOFA评分和中性粒细胞/淋巴细胞比值(NLR)对社区获得性肺炎(CAP)死亡率的预测价值。方法回顾性分析2016年1月-2018年12月间安徽医科大学第二附属医院呼吸与危重医学科收治的196例CAP患者的临床资料,所有病例均符合纳入排除标准。入院后24 h内测量生命体征,并在抗生素治疗前收集患者静脉血,测定血清生化等指标,通过比较受试者工作特征曲线(ROC)分析CURB-65、A-DROP、q-SOFA和NLR对患者30 d死亡率的预测效能。结果196例患者30d死亡率为12.7%,CURB-65、A-DROP、q-SOFA和NLR预测死亡率的曲线下面积分别是0.73、0.63、0.69和0.69。结论CURB-65、A-DROP、q-SOFA和NLR均可用于CAP死亡率的预测。其中CURB-65预测效能最高,但易受到医疗条件的限制;qSOFA检测指标要求不高,利于CAP的快速分级。

Objective To investigate the predictive value of CURB-65 score,A-DROP score,q-SOFA score,and neutrophil/lymphocyte ratio(NLR)for mortality in community acquired pneumonia(CAP).Methods The clinical data of 196 patients with CAP who were treated in the Department of Respiratory and Critical Care Medicine of the Second Affiliated Hospital of Anhui Medical University from January 2016 to December 2018 were retrospectively analyzed.All cases met the exclusion criteria.Vital signs and venous blood were collected within 24 hours after admission and before antibiotics treatment.Serum biochemical parameters were measured,and receiver operating characteristic curve(ROC)was used to analyze CURB-65,A-DROP,q-SOFA and NLR for patients with predictive power of 30-day mortality.Results The 30-day mortality rate of 196 patients was 12.7%,and the areas under the curve of CURB-65,A-DROP,q-SOFA and NLR to predict mortality were 0.73,0.63,0.69 and 0.69,respectively.Conclusion CURB-65,A-DROP,q-SOFA,and NLR are all significant in predicting the prognosis of patients with CAP.CURB-65 is the most effective predictor,but it is easily restricted by medical conditions.q-SOFA detection index requirements are not high,conducive to the rapid grading of CAP.