SMART-COP评分对重症社区获得性肺炎的诊断价值

Diagnostic value of SMART-COP score in diagnosis of severe community-acquired pneumonia

目的 探讨SMART-COP评分对重症社区获得性肺炎（SCAP）的诊断价值.方法 回顾性分析2011年1月至2013年12月成都市第二人民医院社区获得性肺炎（CAP）患者180例,其中SCAP 90例,普通CAP90例,对2组进行SMART-COP评分,以美国胸科学会/美国感染病学会2007年SCAP诊断标准作为金标准绘制SMART-COP评分诊断SCAP的受试者工作特征曲线,获得SMART-COP评分诊断SCAP界值及相应的敏感度、特异度、阳性似然比、阴性似然比和Youden指数.结果 以4分为界值,SMART-COP评分诊断SCAP的效能最高,其敏感度为78.9％,特异度为80.0％,准确率为79.4％,阳性似然比为3.944,阴性似然比为0.264,Youden指数为0.589.结论 根据SMART-COP评分诊断重症肺炎敏感度及特异度均较好,最佳临界值为4分.

Objective To explore the value of SMART-COP score in diagnosis of severe communityacquired pneumonia patients （SCAP）.Methods Totally 180 patients of community-acquired pneumonia （CAP）,including 90 cases of SCAP and 90 cases of common CAP,were retrospectively analyzed.The SMART-COP score was assessed.The receiver operating characteristic （ROC） curve of SMART-COP score in diagnosing SCAP was drawn by taking the standard of American Thoracic Society/Infectious Diseases Society of America statement as gold standard,and the sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio and Youden index were obtained.Results Taking 4 scores as cut-off value,the value of SMART-COP in diagnosing SCAP was high,with sensitivity of 78.9％,specificity of 80.0％,positive likelihood ratio of 3.944,negative likelihood ratio of 0.264 and Youden index of 0.589.Conclusion The sensitivity and specificity of SMART-COP score in diagnosing SCAP is high with cut-off value of 4.