中国社区获得性肺炎病情评估标准与Fine危险分层的临床对比研究

Comparison between the severity criteria of the Chinese guidelines for community acquired pneumonia and Fine′s risk classes

目的 验证 1998年中华医学会制订的社区获得性肺炎 (CAP)诊断和治疗指南中病情评估标准筛选住院患者、判断重症肺炎的能力 ,为全面实施诊疗指南提供依据。方法 以 2 0 0 1年 9月～ 2 0 0 2年 3月收治住院的 13 7例CAP患者为对象 ,通过回顾性研究 ,应用SPSS 10 0统计分析软件 ,比较中国CAP诊疗指南中病情评估标准与Fine危险分层的相关性 ;比较中国CAP病情评估标准所分各组患者在住院天数、住院费用、静脉输液天数、危险因素数目、病死率等方面的差异。结果 (1)中国病情评估标准与Fine危险分层有很好的相关性 (P <0 0 0 1,相关系数为 0 60 1) ;(2 )按中国CAP病情评估标准 ,不符合住院标准组与符合住院标准组患者在住院天数、住院费用、静脉输液天数等方面差异有显著性 (P <0 0 1) ;符合住院标准组与重症肺炎组在危险因素数目、病死率方面差异有显著性(P <0 0 1)。结论 (1)中国CAP病情评估标准能准确区分不同风险组患者 ;(2 )Fine分层同样适用国人 ;(3 )

Objective To validate the Chinese guidelines for community acquired pneumonia (CAP) in evaluating severe pneumonia and hospitalization criteria for the implementation of the Chinese guidelines accordingly Methods The medical records of 137 inpatients with CAP in the hospital from September 1, 2001 to March 31, 2002 were retrospectively studied and analyzed with SPSS 10 0 Chi square test and ANOVA were used to compare severity criteria of the Chinese guidelines with Fine′s risk classes Statistical differences in age, duration of hospitalization, cost, duration of intravenous therapy, number of risk factors, and the mortality of the three subgroups stratified by the severity criteria of the Chinese guidelines were also analyzed Results (1) The correlation was significant between the severity criteria of the Chinese guidelines and Fine′s risk classes ( P <0 001, Pearson coefficient 0 601); (2) The differences in age, duration of hospitalization, cost, duration of intravenous therapy, number of risk factors and mortality were statistically significant between patients who met the hospitalization criteria and patients who did not base on the severity criteria of the Chinese guidelines ( P < 0 001) The number of risk factors and the mortality in patients with severe pneumonia were significantly higher than those in other groups ( P <0 01) Conclusions The severity criteria of the Chinese CAP guidelines can differentiate patients with different risks. Fine′s risk classification is useful for evaluating Chinese patients with CAP. The current Chinese guidelines for the management of CAP should be implemented