三种评价量表对重症社区获得性肺炎患者通气方式的预测意义

目的 探讨3种重症社区获得性肺炎(CAP)危重度分层评分量表SMART-COP、CURB-65和IDSA/ATS对患者通气方式的预测意义. 方法 采集98例重症CAP患者入院时的相关数据,分别计算SMART-COP、CURB-65和IDSA/ATS次要标准的计分,根据患者24 h内实际采用的通气方式来评估此3种评价量表对通气方式的预测价值. 结果 3种评分量表的分值高低对预测患者采取非有创通气或有创通气均有统计学意义(P<0.05).3种评分量表的ROC曲线下面积比较,SMART-COP较CURB-65和IDSA/ATS次要标准有更强的预测能力(P<0.05),而CURB-65与IDSA/ATS次要标准之间无明显差异(P>0.05). 结论 3种评分量表对重症CAP患者通气方式均有一定预测价值,相比而言,SMART-COP比CURB-65和IDSA/AT次要标准更具有优势.

The Predictive Value of Three Scales on Ventilatory Pattern Choice in Patients with Severe Community-acquired Pneumonia

Objective To evaluate the predictive value of three scales, including SMAT-COP, CURB-65 and the minor criteria for severe community-acquired pneumonia (CAP) proposed by IDSA/ATS, on the ventilatory pattern choice in patients with severe community-acquired pneumonia. Methods The scores of the three scales were calculated in 98 patients with severe CAP with the admission data, and compared between the non-invasive ventilation group and invasive ventilation group. Results There were significant differences in SMAT-COP, CURB-65 and IDSA/ATS minor criteria between non-invasive ventilation group and invasive ventilation group (P< 0. 05). The area under the ROC curve indicated that SMAT-COP had better predictive values than CURB-65 and IDSA/ATS minor criteria (P<0. 05). But there was no significant difference between CURB-65 and IDSA/ATS minor criteria (P>0. 05). Conclusion The three scales all have predictive values on ventilatory pattern choice in patients with severe CAP.SMART-COP has better predictive values than the other two.