临床肺部感染评分对卒中相关性肺炎的诊断及预后评价的价值

The diagnosis and prognosis value of clinical pneumonic infection score in patients with stroke. associated pneumonia

目的探讨临床肺部感染评分（CPIS）对卒中相关性肺炎（SAP）诊断及预后评价的价值。方法对150例卒中患者均采用CPIS进行诊断及预后分析，以最终发生SAP为金标准，计算CPIS的灵敏度、特异度、诊断符合率、阳性预测值、阴性预测值，并进行预后评价。结果行CPIS有SAP发生患者39例，未发生SAP患者111例，而最终SAP的发生率为22．O％（33／150）。CPIS诊断SAP的灵敏度为84．8％（28／33），特异度为90．6％（106／117），阳性预测值为71．8％（28／39），阴性预测值为95．5％（106／111），诊断符合率为89．3％（134／150）。将最终发生SAP患者根据其预后情况分为预后良好（28例）和预后不良（5例），SAP后7d预后良好患者CPIS明显低于预后不良患者[（4．21±2．23）分比（6．05±2．32）分，P〈0．05]。结论CPIS对SAP不仅诊断率比较高，而且能较好地判定预后，值得临床推广应用。

Objective To explore the diagnosis and prognosis value of clinical pneumonic infection score （CPIS） in patients with stroke-associated pneumonia （SAP）. Methods One hundred and fifty stroke patients were evaluated and analyzed by CPIS. SAP was regarded as gold standard, and sensitivity, specificity, diagnose accordance rate, positive predictive value and negative predictive value were calculated. Results Thirty-nine patients had SAP and 111 patients did not have SAP by CPIS, and the incidence of SAP was 22.0% （33/150）. CPIS diagnostic sensitivity was 84.8% （28/33）, specificity was 90.6% （ 106/117 ）, positive predictive value was 71.8% （28/39）,negative predictive value was 95.5% （106/111）,and diagnose accordance rate was 89.3%（134/150）. The patients of SAP were divided into good prognosis （28 cases ） and bad prognosis （5 cases ）, and the CPIS was significantly lower in patients of good prognosis 7 days after SAP than that in patients of bad prognosis [（4.21 ± 2.23） scores vs. （6.05 ±2.32） seores,P 〈0.05]. Conclusions Not only CPIS has higher diagnosis rate in SAP incidence,but also has good judgment to prognosis. It is worthy of clinical application.