临床肺部感染评分和C-反应蛋白在老年社区获得性肺炎预后评估中的应用

目的探讨C反应蛋白（CRP）及临床肺部感染评分（CPIS）对老年社区获得型肺炎（CAP）患者预后的评估作用。方法对102例老年CAP患者进行分析，记录入院第1天、第7天的CRP、CPIS、白细胞计数（WBC）。根据预后将患者分为存活组和死亡组，比较两组CRP、CPIS、WBC的差别。结果治疗7天后存活组的CRP、WBC和CPIS，与人院时比较明显下降（P〈0．05），死亡组与人院时比较无差异（P〉0．05）；死亡组的CRP和CPIS明显高于存活组（P〈0．01）。结论动态监测CRP和CPIS对于评价老年CAP预后具有重要的临床意义。特别是对于临床表现不典型的老年CRP患者，同时动态监测这两项指标意义更大。

Using clinical pulmonary infection score and C-reactive protein to evaluate prognosis of the elderly patients with community-acquired pneumonia

Objective To study the changes on C-reactive protein（CRP） and clinical pulmonary infection score（CPIS） in aged patients with community acquired pneumonia（CAP） and the value in evaluation of the prognosis. Methods 102 elderly patients with CAP were analyzed, CRP, CPIS and white blood cell（WBC） were measured on the 1 st and the 7 th days after admission. CAP patients were divided into the fatal group and survival group. The difference of observations were compared between the two groups. Results The levels of CRP（2. 36 ± 1.52） mg/dL,WBC（7. 13 ±4. 62 × 109/L） and CPIS（2.35 ±2. 16） declined significantly in the survival group（P 〈0. 05）, While that was not significantly different in the fatal group（ P 〉 0. 05 ）. The levels of CRP, WBC and CPIS of the fatal group were much higher than those of the survival group! P 〈 0. 01 ）. Conclusion Dynamic monitoring of CRP and CPIS for evaluating prognosis in elderly CAP has an important clinical significance, especially for the elderly with atypical clinical manifestations in patients with CRP, while dynamic monitoring of these 2 indicators is more meaningful.