CURB-65、PSI、SMART-COP及APACHEⅡ评分在重症社区获得性肺炎患者早期诊断价值的比较

来源期刊：广州医药 | 9-12 发布时间：2021-11-29 收稿时间：2025/11/13 17:18:10 阅读量：36

作者：: 方昌全,

林俊鸿,

李裕军,

魏树全,

赵祝香,

李晓岩,

钟维农,

赵子文,

关键词：: CURB-65 PSI SMART-COP APACHEⅡ 社区获得性肺炎; CURB-65 PSI SMART-COP APACHEⅡ Community-acquired pneumonia

DOI：: 10.3969/j.issn.1000-8535.2018.05.003

收稿时间：: 2018-05-09
修订日期：
接收日期：
引用总数：: 0

目的探讨及比较CURB-65、PSI、SMART-COP及APACHEⅡ 4种临床评分对重症社区获得性肺炎(SCAP)患者的早期诊断价值。方法采用前瞻性研究方法,收集2011年10月—2014年2月广州市第一人民医院呼吸内科收治的67例SCAP及同期33例普通CAP患者的临床资料,记录入组后24小时内CURB-65、PSI、SMART-COP及APACHEⅡ评分的最差值,比较4种临床评分系统对SCAP的早期诊断价值。结果 SCAP组CURB-65、PSI、SMART-COP及APACHEⅡ评分均高于普通CAP组患者[CURB-65(分):3.06±1.10 比0.85±0.79,P<0.001;PSI(分):144.93±36.48比73.94±27.17,P<0.001; SMART-COP(分):6.54±1.41比 1.67±1.02,P<0.001; APACHEⅡ(分):20.79±5.69比7.94±3.87,P<0.001]。CURB-65≥3分、PSI≥130分、SMART-COP≥3分及APACHEⅡ≥15分诊断SCAP的受试者工作特征曲线(ROC)下面积(AUC)分别为0.940[95% CI:0.89~0.98, P<0.001],0.933[95%CI:0.88~0.97,P<0.001],0.999[95%CI:0.99~1.0,P<0.001],0.976[95%CI:0.95~0.99,P<0.001],敏感度分别为65.6%、71.6%、100%、88.1%,特异度分别为100%、100%、78.7%、93.9%。结论 CURB-65及PSI评分特异度好,但敏感度低,易漏诊,SMART-COP和APACHE Ⅱ评分诊断效能更佳。

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