临床肺部感染评分在急性呼吸窘迫综合征患者病情及预后评估中的价值

Value of clinical pulmonary infection score in evaluation of severity and prognosis of acute respiratory distress syndrome

目的研究临床肺部感染评分(CPIS)在急性呼吸窘迫综合征(ARDS)患者病情及预后评估中的应用价值,为指导ARDS的临床治疗提供参考。方法将医院ICU收治的132例ARDS患者根据病情分为A组30例、B组61例、C组41例;同时根据患者1周内预后情况分为存活组50例和死亡组82例,比较分析各组患者CPIS评分、住院时间、MODS发生率及病死率。结果 CPIS评分A组(4.15±0.73)分、B组(7.59±1.71)分,两组比较,B组显著升高,差异有统计学意义(t=10.53,P<0.05),B组与C组比较,CPIS评分C组(10.02±2.51)分,C组显著升高,差异有统计学意义(t=5.82,P<0.05);随着ARDS病情的加重,患者病死率依次增加,差异有统计学意义(χ2=15.20,P<0.05);入院第1、3天,两组患者CPIS评分差异无统计学意义;入院第5、7天,死亡组CPIS评分显著高于存活组(P<0.05);与存活组比较,死亡组ICU住院时间明显延长,总住院时间明显缩短(P<0.05);死亡组MODS发生率为64.0%,显著高于存活组19.5%(P<0.05)。结论 CPIS评分可作为评定其病情危重程度和预测死亡风险的重要指标。

OBJECTIVE To explore the value of clinical pulmonary infection score（CPIS） in the evaluation of severity and prognosis of acute respiratory distress syndrome（ARDS） so as to guide the clinical treatment of ARDS. METHODS According to the severity of disease, 132 ARDS patients who were admitted in ICU were divided into three groups, including 30 patients of Group A （4.15±0.73）, 61 patients of Group B, 30 patients of Group C. All the patients were also：divided into the survivor group and the death group according to the prognosis in one week. CPIS score, hospital stays, incidence of MODS and mortality were compared among the groups. RESULTS Compared with Group A （4. 15 ± 0. 73）, CPIS score in Group B （7. 59 ± 1. 71） was significantly increased （t= 10. 53, P〈0. 05）, and compared with Group B, CPIS score in Group C（10. 02±2. 51） was significantly increased （t= 5. 82, P〈0. 05）. With the severity aggravating, the mortality was increased （P〈 0.05）. There was no significant difference in the CPIS score between the 1st day and 3rd day after the admission, while CPIS score in death group on the 5th day and 7th day after admission was significantly higher than that in the survivor group （P〉0.05）. Compared with the survivor group, the hospital stay in ICU was lengthened significantly, and the total hospital stay was significantly shortened （P〈0.05）. The incidence of MODS in the death group was 64.0 %, significantly higher than 19.5 % in the survivor group （P〈0.05）. CONCLUSION CPIS score can be served as an important indicator in the evaluation of severity and prognosis of the ARDS patients.