急性脑卒中并发肺炎的预测量表评定

目的:评估急性脑卒中并发肺炎预测量表的准确性和有效性。方法:采用脑卒中后肺炎预测量表对312例急性脑卒中患者进行入院时评分, 并观察住院期间发生肺炎的病例数。应用受试者工作曲线分析量表的准确性;计算量表的敏感度、特异度、阳性预测值、阴性预测值、阳性似然比和阴性似然比来验证有效性。结果:急性脑卒中肺炎的发生率为18.9%, 肺炎的发生率与分值呈明显正相关关系(P<0.01);构建受试者工作曲线, 求得曲线下面积为0.836(95%CI 0.779~0.894, P<0.01);若使敏感度和特异度均>0.50, 以取3分值为最佳, 其敏感度69.5%、阳性预测值52.7%及阳性似然比3.663, 而特异度81.0%、阴性预测值89.7%及阴性似然比0.377。该量表的准确性达83.6%。结论:急性脑卒中并发肺炎预测量表在检出急性脑卒中并发肺炎的发生能力有一定的局限性, 但对于排除急性脑卒中并发肺炎的能力较强;在基层医院临床工作中, 对急性脑卒中并发肺炎的初步预测有一定的实际应用价值。

The application value of predication scale of pneumonia after acute stroke

Objective:To evaluate the accuracy and validity of predication scale of pneumonia after acute stroke. Methods:The scores of 312 patients with acute stroke during the admission to hospital were evaluated using the predication scale of pneumonia, and the number of patients infected with pneumonia were observed in the duration of hospital. The accuracy of the predication scale was analyzed using the receiver operating characteristic,the sensitivity,specificity,positive predictive value,negative predictive value,negative likely ratio and positive likely ratio of the predication scale were used to validate its validity. Results:The occurrence rate of pneumonia was 18. 9%,which was significantly positive correlation with the score of scale(P<0. 01). The receiver operating characteristic curve was established,the area under curve was 0. 836(95%CI 0. 779 to 0. 894,P<0. 01). When both sensitivity and specificity were more than 0. 50 and taking 3 points was the best,the sensitivity,positive predictive value and positive likely ratio,and the specificity,negative predictive value and negative likely ratio were 69. 5%,52. 7% and 3. 663,and 81. 0%,89. 7% and 0. 377,respectively. Conclusions:The accuracy of the predication scale of pneumonia after acute stroke is 83. 6%. The validity of scale in detecting of pneumonia after acute stroke has certain limitation,but in excluding pneumonia after acute stroke its value is high. The predication scale has certainly practical value in the predication of pneumonia after acute stroke.