CPIS在ARDS患儿病情及预后评估中的意义

目的探讨动态，临床肺部感染评分（CPIS）监测在急性呼吸窘迫综合征（ARDS）患儿病情及预后评估中的临床应用价值。方法收集2008年12月-2012年12月重症监护室（ICU）收治的ARDS患儿86例，经过积极治疗后86例ARDS患儿死亡46例，存活40例。统计分析两组CPIS的动态变化。结果生存组患儿第1，3，7天CPIS分别为6．12±1．38、7．83±1．57和5．34±1．13分，死亡组患儿第1，3，7天CPIS分别为6．94±1．42、8．70±1．56和9．55±1．62分。生存组患儿在第1，3，7天时CPIS均显著低于死亡组患儿（P〈0．05），生存组CPIS第3天时CPIS达到高峰（P〈0．05），以后逐渐减低（P〈0．05），而在死亡组随着时间的推移CPIS则逐渐升高（P〈0．05）。40例生存组ARDS患儿中有9例发展到多器官功能衰竭（MOF），发生率为22．5％，g6例死亡组ARDS患儿中有43例发展到MOF，发生率为93．5％，统计学分析显示两组之间差异有统计学意义（P〈0．01）。结论动态监测CPIS的变化可以反应出ARDS患儿的病情变化，可作为其预后评估的简易指标之一。

The Prognosis Value of Ambulatory Monitoring CPIS in ARDS Children and Its Clinical Significance

Objective To investigate the prognosis value of ambulatory monitoring clinical pulmonary infection score（CPIS） in children with acute respiratory distress syndrome（ARDS）. Methods A total of 86 cases of ARDS children were enrolled in our study. After treatment ,46 cases of ARDS children were died, and 40 cases of ARDS children were survival. The CPIS of the two groups was ambulatory monitored and statistically analyzed. Results The CPIS in survival group was 6.12 ± 1.38,7.83± 1.57, and 5.34 ± 1.13 at 1,3,7 day, and in dead group was 6.94 ± 1.42,8.70± 1.56, and 9.55 ±1.62 at 1,3,7 day. Which was lower in survival group than that in dead group at 1,3,7 day（P 〈0.05）. In survival group the CPIS reached peak at 3 day（P 〈 0.05 ） , and decreased at 7 day（ P 〈 0.05 ）. However, in dead group the CPIS was decreased according to time disappear（ P 〈 0.05）.9 case in 40 survival children developed into MOF with a rate of 22.5%. 43 cases in 46 died children developed into MOF with a rate of 93.5%. There was significant difference between the two groups （ P 〈 0.05 ）. Conclusion The ambulatory monitoring CPIS may be used as a simple indicator to evaluate the condition and prognosis of ARDS children.