临床肺部感染评分在呼吸机相关性肺炎预后评估中的价值

摘要

目的：探讨临床肺部感染评分（CPIS）在呼吸机相关性肺炎（VAP）预后评估中的价值。方法57例VAP患者根据临床转归分为生存组和死亡组，动态监测两组患者入院第1d、第5d及转出或死亡前CPIS评分及APACHEⅡ评分的动态变化，并分析两者之间的相关性。结果两组患者在年龄、入住ICU时间、机械通气时间、CPIS评分及APACHEⅡ评分等方面比较无显著差异性（P>0.05）；生存组第5d和转出前CPIS评分及APACHEⅡ评分等指标明显低于死亡组（P<0.05）；CPIS评分与APACHEⅡ评分呈正相关（r=0.527, P<0.01）。结论动态监测CPIS评分对VAP患者预后评估具有较好的临床价值。%Objective To discuss the value of clinical pulmonary infection score (CPIS) in evaluating the prognosis of ventilator-as-sociated pneumonia (VAP). Methods 57 cases with VAP were, according to the clinical outcome, divided into 2 groups:survival group (n=33) and death group (n=24);dynamic monitoring was made to the scores of CPIS and APACHE II of the cases in both groups at the time point of the 1st day and the 5th day after admission, recovery or death;the correlation between the changes of CPIS and APACHE II was analyzed. Results There existed no obvious difference in age, the duration in ICU, mechanical ventilation time, scores of CPIS and APACHE II between the 2 groups (P>0.05);the scores of CPIS and APACHE II at the time point of the 5th day of admission and re-covery or death in survival group were much lower than those in death group (P>0.05);there existed a positive correlation between the scores of CPIS and the scores of APACHE II (r=0.527,P<0.01). Conclusions Dynamic monitoring of CPIS is of good clinical value in evaluating the prognosis of the cases with VAP.