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3种肺部感染评分系统在肾移植术后肺部感染中的应用价值比较

李智斌 张更 马帅军 刘克普 阮东丽 秦卫军 袁建林

李智斌, 张更, 马帅军, 等. 3种肺部感染评分系统在肾移植术后肺部感染中的应用价值比较[J]. 器官移植, 2016, 7(3): 196-200. doi: 10.3969/j.issn.1674-7445.2016.03.007
引用本文: 李智斌, 张更, 马帅军, 等. 3种肺部感染评分系统在肾移植术后肺部感染中的应用价值比较[J]. 器官移植, 2016, 7(3): 196-200. doi: 10.3969/j.issn.1674-7445.2016.03.007
Li Zhibin, Zhang Geng, Ma Shuaijun, et al. Comparison of application value of three pulmonary infection scoring systems in pulmonary infection after renal transplantation[J]. ORGAN TRANSPLANTATION, 2016, 7(3): 196-200. doi: 10.3969/j.issn.1674-7445.2016.03.007
Citation: Li Zhibin, Zhang Geng, Ma Shuaijun, et al. Comparison of application value of three pulmonary infection scoring systems in pulmonary infection after renal transplantation[J]. ORGAN TRANSPLANTATION, 2016, 7(3): 196-200. doi: 10.3969/j.issn.1674-7445.2016.03.007

3种肺部感染评分系统在肾移植术后肺部感染中的应用价值比较

doi: 10.3969/j.issn.1674-7445.2016.03.007
详细信息
    通讯作者:

    袁建林,Email:jianliny@fmmu.edu.cn

  • 中图分类号: R617, R563

Comparison of application value of three pulmonary infection scoring systems in pulmonary infection after renal transplantation

More Information
  • 摘要:   目的  比较PSI、CURB-65以及SMART-COP评分系统用于评估肾移植术后肺部感染严重程度和预测预后的价值。   方法  回顾性分析2009年1月至2015年6月西京医院收治的71例肾移植术后肺部感染患者的临床资料,其中重症感染组27例、非重症感染组44例。根据3种评分系统的危险分层标准将患者分成低危组和中、高危组。比较3种评分系统的不同危险分组患者的病死率、呼吸机使用率、重症监护室(ICU)入住率和住院时间。比较重症感染组与非重症感染组在3种评分系统中的得分差异。通过受试者工作特征(ROC)曲线比较3种评分系统预测患者肺部感染病死率的效能。   结果  在3种评分系统中,中、高危组患者的病死率、呼吸机使用率、ICU入住率较低危组明显升高(均为P < 0.05),所有中、高危组患者的住院时间均长于低危组(均为P<0.05)。重症感染组的PSI、CURB-65、SMART-COP评分的得分均明显高于非重症感染组(均为P<0.05)。PSI、CURB-65和SMART-COP评分评估死亡的最佳截点值分别为75分、1.5分和3.5分,其预测肾移植术后肺部感染病死率的灵敏度、特异度和曲线下面积(AUC)分别为0.929、0.890、0.909,0.857、0.772、0.844,0.929、0.860、0.941。  结论  PSI、CURB-65及SMART-COP评分均能反映肾移植术后肺部感染患者的病情严重程度和预测病死率,其中SMART-COP预测患者的病死率最准确,而PSI灵敏度高但操作复杂,CURB-65应用简单、方便。

     

  • 图  1  3种评分系统预测肾移植术后肺部感染病死率的ROC曲线

    Figure  1.  The ROC curve to evaluate 3 kinds of scaling systems on the mortality of pulmonary infection after renal transplantation

    表  1  各评分系统不同危险分层的病死率、呼吸机使用率、ICU入住率及住院时间

    Table  1.   Mortality rates, ventilator frequency, ICU occupancy, and length of stay of each scaling system[n(%)]

    评分系统 n 死亡 使用呼吸机 入住ICU 住院时间(x±s, d)
    PSI
     低危组 59 5(9) 10(17) 4(7) 16±10
     中、高危组 12 9(75)a 11(92)a 5(42)a 26±14a
    CURB-65
     低危组 46 2(4) 3(7) 0(0) 14±10
    160中、高危组 25 12(48)a 18(72)a 9(36)a 24±11a
    SMART-COP
     低危组 45 1(2) 0(0) 0(0) 13±9
     中、高危组 26 13(50)a 21(81)a 9(35)a 25±13a
    注:与同一系统评分的低危组比较,aP<0.05
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出版历程
  • 收稿日期:  2015-01-28
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2016-05-15

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