再谈卫生保健相关性肺炎的研究进展：现状与争议

Research process of healthcare-associated pneumonia： status and controversy

卫生保健相关性肺炎（HCAP）是美国胸科学会与感染病学会2005年发布的“成人医院获得性肺炎、呼吸机相关性肺炎和卫生保健相关性肺炎治疗指南”中提出的概念。此类患者虽来源于院外，但其流行病学、治疗、预后与社区获得性肺炎存在差异，反而与医院获得性肺炎有诸多重叠。但随着相关研究增多，近期发表的欧美指南不再使用HCAP，而日本新指南则继续保留了HCAP。因此应全面且正确认识HCAP，了解目前国内外的研究现状，以便更好指导治疗，改善这部分患者的预后。

Healthcare associated pneumonia （HCAP） is a concept defined in the ′ American Guideline for the Treatment of Hospital Acquired Pneumonia, Ventilator-Associated Pneumonia and Health-Care-Related Pneumonia′ published by the American Thoracic Society and Infectious Diseases Society of America （ATS/IDSA） in 2005. Although patients of HCAP were from the community, the epidemiology, treatment and prognosis of HCAP differed much from those of community-acquired pneumonia （CAP）, but were more closely resemble hospital-acquired pneumonia （HAP）. However, after a series of further research, HCAP was excluded from the HAP/ventilator associated pneumonia （VAP） guidelines published in Europe or America recently, while still included in the new Japanese guidelines. Therefore, it is significant to develop a comprehensive view on HCAP by investigating the latest research both at home and abroad, in order to provide appropriate antimicrobial therapy and improve the prognosis of these patients.