ASS 与 CPIS 评分评估重型颅脑损伤继发感染的临床价值

摘要

目的：探讨全身炎症反应综合征修正评分（ASS评分）与肺部感染评分（CPIS评分）评估重型颅脑损伤继发感染的临床价值，以期提高临床治疗水平。方法选取2011‐01—2013‐0448例重型颅脑损伤继发感染患者为研究对象，以住院存活情况、ICU时间、住院时间和感染控制情况作为预后评估标准，结合患者特征曲线（ROC）比较ASS评分与CPIS评分系统的预测能力。结果 CPIS评分最佳诊断阈值为7，敏感度为0.789，特异性为0.923，阳性预测值为0.715，阴性预测值为0.864，Youden指数为0.724，特征曲线下面积为0.836；ASS评分最佳诊断阈值为11，敏感度为0.726，特异性为0.967，阳性预测值为0.813，阴性预测值为0.878，Youden指数为0.668，特征曲线下面积为0.837。两个评分比较差异性无统计学意义（P＞0.05）。结论 ASS评分与CPIS评分可对重型颅脑损伤继发感染进行量化评估。%Objective To investigate the clinical value of systemic inflammatory response syndrome score (ASS score) and pulmonary infection score (CPIS score) evaluating the secondary infection of patients with severe traumatic brain injury. Meth‐ods Totally 48 severe traumatic brain injury patients with secondary infection in our hospital from January 2011 to 2013 April were considered as the study objects. The hospital survival ,ICU time ,hospitalization time and infection control situation of pa‐tients were considered as the assessment criteria of prognosis combining patients’ characteristic curve (ROC) to compare the predictive ability of ASS and CPIS scoring system. Results The scoring system characteristics of CPIS were 7 best diagnostic thresholds ,0.789 sensitivity ,0.923 specificity ,0.715 positive predictive values ,and 0.864 negative predictive values ,0.724 Youden index ,0.836 characteristic areas under the curve. The scoring system characteristics of ASS were 11 best diagnostic thresholds ,0.726 sensitivity ,0.967 specificity ,0.813 positive predictive values ,and 0.878 negative predictive values ,0.668 Youden index ,0.837 characteristic areas under the curve. There was no statistical difference between two scoring system.Conclusion ASS and CPIS score can quantitatively evaluate the secondary infection of patients with severe traumatic brain inju‐ry.