社区获得性肺炎证候诊断标准的验证

对建立的社区获得性肺炎证候诊断标准(拟定)的进行考核、验证。方法:随机选择600例肺炎患者,以专家辨证为参照,所有受试者均同时接受专家辨证与标准辨证,应用盲法判定结果,运用SPSS 13.0 for windows统计软件包,考核该诊断标准的灵敏度、特异度、准确度。结果:在600例患者中,各证的灵敏度范围为74.2%～87.4%;特异度为87.3%～97.2%;准确度为86.2%～94.7%。阳性预测值中,肺脾气虚证较低为48.5%;阴性预测值在90.6%～98.5%之间。阳性似然比值均较高(6.18～26.5),阴性似然比值均较小于1(0.14～0.27)。392例老年人肺炎患者中,各证灵敏度为70.3%～89.0%;特异度为90.2%～96.7%;准确度为87%～94.6%。阳性预测值中,肺脾气虚证最低为53.6%,而痰热雍肺证最高为90.7%;阴性预测值均在92.3%～97.5%之间;阳性似然比值均较高(7.61～21.79),阴性似然比值均较小于1(0.12～0.33)。208例非老年人肺炎患者中,痰热壅肺证的灵敏度最高为91.3%,余证在70%～75%之间;各证特异度(89.7%～96.9%)和准确度(86.5%～95.2%)均较高。阳性预测值为63.7%～87.5%,而阴性预测值则为92.7%～97.9%。阳性似然比值均较高(7.371～24.19),阴性似然比值均较小于1(0.19～0.33)。结论:所建立的社区获得性肺炎证候诊断标准具有较高的灵敏度、特异度和准确度,不仅能适用于老年人肺炎,同样也适用于非老年人肺炎。肺脾气虚证的诊断标准尚需进一步研究和修订。

Validation of the Established Syndrome Diagnostic Criteria for Community Acquired Pneumonia

Objective:To examine and validate the established syndrome diagnostic criteria for community acquired pneumonia(CAP).Methods:600 cases of pneumonia patients were randomly selected,and with expert syndrome differentiation for reference,all subjects also received expert and standard Syndrome Differentiation,using the method of blind judge result and using SPSS 13.0 for windows statistical package to evaluate the sensitivity,specificity and accuracy of the diagnostic criteria.Results:In 600 patients,the sensit...