PSI和CURB-65评分对老年社区获得性肺炎初始疗效的评估

Effect of PSI and CURB-65 score on evaluation of the initial treatment response in old community acquired pneumonia patients

目的研究肺炎严重度指数(PSI)和CURB-65评分对于评价老年社区获得性肺炎(CAP)患者初始抗生素治疗效果的作用。方法选取2008年1月12日首都医科大学宣武医院急诊科病房79例老年CAP患者,入院后第1天和第4天时分别进行PSI和CURB-65评分,根据治疗效果分为有效组和无效组,比较PSI和CURB-65评分的差别。结果 79例老年CAP患者PSI和CURB-65评分在治疗有效组显著下降,无效组显著上升。当两项指标联用时,敏感性和特异性均明显提高。结论检测入院后第1天和第4天的PSI和CURB-65评分的变化有助于判断老年CAP患者的初始治疗效果。

Objective To study the effect of pneumonia severity index（PSI）and CURB-65 score on evaluation of initial treatment response in old community acquired pneumonia（CAP）patients.Methods To enroll 79 elderly CAP patients from Jan,2008 to Dec,2008.They were recorded PSI and CURB-65 on the 1st and the 4th day after admission.They were divided into response group and nonresponse group according to the outcome after the initial treatment.Results Seventy-nine elderly patients with CAP were enrolled.PSI and CURB-65 score were significantly decreased in the response group,whereas those were significantly increased in the nonresponse group separately.If combined of these two indicators,sensitivity and specificity could be improved.Conclusion Dynamic observation of PSI and CURB-65 on the 1st day and the 4th day could be useful in predicting elderly CAP patients of nonresponse initial treatment.