目的 探讨改良型CURB-65评分在评估急诊患者社区获得性肺炎(community-acquired pneumonia,CAP)严重程度中的临床应用价值.方法 选择2011年5月至2012年5月期间收住南京市第一医院符合CAP诊断的198例急诊患者,分别应用CURB-65及改良型CURB-65评分进行评估,根据CAP严重程度分为轻症肺炎组(A组107例)、重症肺炎组(B组91例),并记录白细胞总数、降钙素原、肺炎严重指数、住院天数、住院费用,进行成组t检验比较.B组分为存活亚组(62例)与死亡亚组(29例),进行CURB-65及改良型CURB-65评分成组t检验比较.采用Pearson等级相关法分析CURB-65及改良型CURB-65评分与降钙素原、肺炎严重指数、住院天数、住院费用的相关性.结果 B组患者的降钙素原、肺炎严重指数、住院天数、住院费用、CURB-65评分、改良型CURB-65评分显著高于A组[(3.70±0.83) vs.(1.27±0.24),t=28.91,P＜0.01; (121.33 ±16.74) vs.(73.79±9.21),t=25.23,P＜0.01; (25.79±10.13) vs.(14.85±6.83),t=9.02,P＜0.01; (22.71 ±3.84)vs.(9.83±1.24),t=32.76,P＜0.01;(3.69±1.03)vs.(3.32±1.06),t=2.48,P＜0.05; (4.21±1.13) vs.(3.41±0.96),t=5.39,P＜0.0l],而白细胞总数比较则差异无统计学意义[(17.58±5.99) vs.(16.86±4.41),t=0.97,P ＞0.05);在B组患者中,改良型CURB-65评分死亡亚组明显高于存活亚组,两组比较差异具有统计学意义[(4.75±1.17) vs.(4.01±1.09),t=2.95,P＜0.01],而CURB-65评分两者差异无统计学意义[(4.0l±1.15)vs.(3.58±0.97),t=1.86,P＞0.05];CURB-65仅与降钙素原呈正相关P＜0.05 (r=0.803,P=0.025),与肺炎严重指数、住院天数、住院费用无明显相关性P＞0.05(r=0.621,P=0.320; r=0.701,P=0.231;r=0.675,P=0.256);改良型CURB-65评分与降钙素原、肺炎严重指数、住院天数、住院费用呈显著正相关P＜0.01 (r=0.951,P=0.003;r=0.965,P=0.002;r=0.947,P=0.004;r=0.961,P=0.002).结论 对于急诊患者,改良型CURB-65评分较CURB-65评分能更有效评估CAP的严重程度并判断预后.
目的 探討改良型CURB-65評分在評估急診患者社區穫得性肺炎(community-acquired pneumonia,CAP)嚴重程度中的臨床應用價值.方法 選擇2011年5月至2012年5月期間收住南京市第一醫院符閤CAP診斷的198例急診患者,分彆應用CURB-65及改良型CURB-65評分進行評估,根據CAP嚴重程度分為輕癥肺炎組(A組107例)、重癥肺炎組(B組91例),併記錄白細胞總數、降鈣素原、肺炎嚴重指數、住院天數、住院費用,進行成組t檢驗比較.B組分為存活亞組(62例)與死亡亞組(29例),進行CURB-65及改良型CURB-65評分成組t檢驗比較.採用Pearson等級相關法分析CURB-65及改良型CURB-65評分與降鈣素原、肺炎嚴重指數、住院天數、住院費用的相關性.結果 B組患者的降鈣素原、肺炎嚴重指數、住院天數、住院費用、CURB-65評分、改良型CURB-65評分顯著高于A組[(3.70±0.83) vs.(1.27±0.24),t=28.91,P＜0.01; (121.33 ±16.74) vs.(73.79±9.21),t=25.23,P＜0.01; (25.79±10.13) vs.(14.85±6.83),t=9.02,P＜0.01; (22.71 ±3.84)vs.(9.83±1.24),t=32.76,P＜0.01;(3.69±1.03)vs.(3.32±1.06),t=2.48,P＜0.05; (4.21±1.13) vs.(3.41±0.96),t=5.39,P＜0.0l],而白細胞總數比較則差異無統計學意義[(17.58±5.99) vs.(16.86±4.41),t=0.97,P ＞0.05);在B組患者中,改良型CURB-65評分死亡亞組明顯高于存活亞組,兩組比較差異具有統計學意義[(4.75±1.17) vs.(4.01±1.09),t=2.95,P＜0.01],而CURB-65評分兩者差異無統計學意義[(4.0l±1.15)vs.(3.58±0.97),t=1.86,P＞0.05];CURB-65僅與降鈣素原呈正相關P＜0.05 (r=0.803,P=0.025),與肺炎嚴重指數、住院天數、住院費用無明顯相關性P＞0.05(r=0.621,P=0.320; r=0.701,P=0.231;r=0.675,P=0.256);改良型CURB-65評分與降鈣素原、肺炎嚴重指數、住院天數、住院費用呈顯著正相關P＜0.01 (r=0.951,P=0.003;r=0.965,P=0.002;r=0.947,P=0.004;r=0.961,P=0.002).結論 對于急診患者,改良型CURB-65評分較CURB-65評分能更有效評估CAP的嚴重程度併判斷預後.
목적 탐토개량형CURB-65평분재평고급진환자사구획득성폐염(community-acquired pneumonia,CAP)엄중정도중적림상응용개치.방법 선택2011년5월지2012년5월기간수주남경시제일의원부합CAP진단적198례급진환자,분별응용CURB-65급개량형CURB-65평분진행평고,근거CAP엄중정도분위경증폐염조(A조107례)、중증폐염조(B조91례),병기록백세포총수、강개소원、폐염엄중지수、주원천수、주원비용,진행성조t검험비교.B조분위존활아조(62례)여사망아조(29례),진행CURB-65급개량형CURB-65평분성조t검험비교.채용Pearson등급상관법분석CURB-65급개량형CURB-65평분여강개소원、폐염엄중지수、주원천수、주원비용적상관성.결과 B조환자적강개소원、폐염엄중지수、주원천수、주원비용、CURB-65평분、개량형CURB-65평분현저고우A조[(3.70±0.83) vs.(1.27±0.24),t=28.91,P＜0.01; (121.33 ±16.74) vs.(73.79±9.21),t=25.23,P＜0.01; (25.79±10.13) vs.(14.85±6.83),t=9.02,P＜0.01; (22.71 ±3.84)vs.(9.83±1.24),t=32.76,P＜0.01;(3.69±1.03)vs.(3.32±1.06),t=2.48,P＜0.05; (4.21±1.13) vs.(3.41±0.96),t=5.39,P＜0.0l],이백세포총수비교칙차이무통계학의의[(17.58±5.99) vs.(16.86±4.41),t=0.97,P ＞0.05);재B조환자중,개량형CURB-65평분사망아조명현고우존활아조,량조비교차이구유통계학의의[(4.75±1.17) vs.(4.01±1.09),t=2.95,P＜0.01],이CURB-65평분량자차이무통계학의의[(4.0l±1.15)vs.(3.58±0.97),t=1.86,P＞0.05];CURB-65부여강개소원정정상관P＜0.05 (r=0.803,P=0.025),여폐염엄중지수、주원천수、주원비용무명현상관성P＞0.05(r=0.621,P=0.320; r=0.701,P=0.231;r=0.675,P=0.256);개량형CURB-65평분여강개소원、폐염엄중지수、주원천수、주원비용정현저정상관P＜0.01 (r=0.951,P=0.003;r=0.965,P=0.002;r=0.947,P=0.004;r=0.961,P=0.002).결론 대우급진환자,개량형CURB-65평분교CURB-65평분능경유효평고CAP적엄중정도병판단예후.
Objective To evaluate the clinical application value of modified CURB-65 score for assessing severity of community-acquired pneumonia (CAP) in emergency patients.Methods During the period from May 2011 to May 2012,198 emergency patients with CAP enrolled in this study were evaluated by CURB-65 score and modified CURB-65 score,respectively.Based on the severity of CAP,patients were divided into mild pneumonia group (Group A,n =107) and severe pneumonia group (Group B,n =91).The clinical status and biomarkers (the white blood cell count,procalcitonin,pneumonia severity index,hospitalization days,and hospitalization expenses) were recorded and compared with t test.Group B was divided into survived-subgroup (n =62) and death-subgroup (n =29).The differences in CURB-65 score and modified CURB-65 scere between the two groups were compared with t test.The correlation of CURB-65 score and modified CURB-65 score with procalcitonin,pneumonia severity index,hospitalization days,and hospitalization expenses were determined with Pearson rank correlation method.Results The procalcitonin,pneumonia severity index,hospitalization days,hospitalization expenses,modified CURB-65 score and CURB-65 score in Group B were significantly higher than those in Group A [(3.70 ± 0.83) vs.(1.27±0.24),t=28.91,P＜0.01; (121.33±16.74) vs.(73.79±9.21),t=25.23,P＜0.01;(25.79±10.13) vs.(14.85 ±6.83),t=9.02,P＜0.01; (22.71 ±3.84) vs.(9.83 ±1.24),t=32.76,P＜0.01; (3.69±1.03) vs.(3.32±1.06),t=2.48,P＜0.05; (4.21±1.13) vs.(3.41±0.96),t =5.39,P＜0.01],while no significant difference was observed in the white blood cell count between GroupA and B (17.58 ±5.99 vs.16.86±4.41,t =0.97,P＞0.05).For Group B,the modified CURB-65 score of death-subgroup was significantly higher than that of survived-subgroup [(4.75± ± 1.17) vs.(4.01 ± 1.09),t =2.95,P ＜ 0.01],whilc no significant difference was observed in the CURB-65 score between the death-subgroup and survived-subgroup (4.01 ± 1.15 vs.3.58 ±0.97,t =1.86,P ＞ 0.05).The CURB-65 score positive correlated with the procalcitonin (r =-0.803,P =0.025),and had no obvious correlation with the pneumonia severity index,hospitalization days,and hospitalization expenses (r=0.621,P=0.320; r=0.701,P=0.231; r=0.675,P=0.256); The modified CURB-65 score significantly positively correlated with the procalcitonin,pneumonia severity index,hospitalization days,and hospitalization expenses (r =0.951,P =0.003 ; r =0.965,P =0.002 ; r =0.947,P =0.004 ; r =0.961,P =0.002).Conclusions Compared with the CURB-65 score,the modified CURB-65 score is more efficient in evaluating the severity and prognoses of CAP for emergency patients.
