摘要
目的比较CURB-65评分和改良CURB-65评分评估非HIV感染者肺炎及HIV感染者肺炎患者预后的价值。方法研究纳入206例非HIV感染者肺炎及299例HIV感染者肺炎的住院患者,根据其治疗4周内临床预后分为恶化组和好转组。比较两组患者基本情况及各临床指标的差异,采用受试者工作特征(ROC)曲线比较CURB-65评分和改良CURB-65评分对非HIV感染者肺炎及HIV感染者肺炎临床预后的预测价值。结果对于非HIV感染者肺炎患者,CURB-65评分和改良CURB-65评分的ROC曲线下面积(AUC)分别是0.862和0.848,两者比较差异无统计学意义(Z=0.661,P=0.5084);两个评分的Youden指数分别为60.11%和54.92%。对于HIV感染者肺炎患者,CURB-65评分和改良CURB-65评分的AUC分别为0.588和0.634,两者比较差异无统计学意义(Z=1.416,P=0.1567);两个评分的Youden指数分别为19.53%和20.52%。结论CURB-65评分与改良CURB-65评分均能有效评价非HIV感染者肺炎的临床预后,但两者对HIV感染者肺炎临床预后判断价值均不佳。
Objective To compare the value of CURB-65 score and expanded CURB-65 score in evaluating prognosis of pneumonia in non-HIV infected patient and HIV infected patient.Methods The study included 206 hospitalized pneumonia patients without HIV infection and 299 pneumonia patients with HIV infection.According to their clinical prognosis within 4 weeks of treatment,they were divided into a deterioration group and an improvement group.The basic situation and the differences of clinical indicators between the two groups were compared.The predictive value of CURB-65 score and expanded CURB-65 score for clinical prognosis of pneumonia in non-HIV infected patients and HIV infected patients was compared by using receiver operator characteristic(ROC)curve.Results For the pneumonia patients without HIV infection,the area under ROC curve(AUC)of CURB-65 score and expanded CURB-65 score were 0.862 and 0.848,respectively.There was no significant difference in AUC between CURB-65 score and expanded CURB-65 score(Z=0.661,P=0.5084).The Youden indexes of CURB-65 score and expanded CURB-65 score were 60.11%and 54.92%,respectively.For the pneumonia patients with HIV infection,the AUC of CURB-65 score and expanded CURB-65 score were 0.588 and 0.634,respectively.There was no significant difference between them(Z=1.416,P=0.1567).The Youden index of the two scores was 19.53%and 20.52%,respectively.Conclusions The CURB-65 score and expanded CURB-65 score can effectively evaluate the clinical prognosis of pneumonia in non-HIV infected patients,but their predicted values are limited in evaluating the prognosis of pneumonia in HIV infected patients.
作者
付永佳
付凯
汪玲琴
蒙达礼
蒋忠胜
FU Yongjia;FU Kai;WANG Lingqin;MENG Dali;JIANG Zhongsheng(The Second Ward of Infectious Diseases Department,Liuzhou People’s Hospital,Liuzhou,Guangxi 545006,P.R.China)
出处
《中国呼吸与危重监护杂志》
CAS
CSCD
北大核心
2020年第4期346-350,共5页
Chinese Journal of Respiratory and Critical Care Medicine
基金
十三五国家科技重大专项子课题(2018ZX10302104-001-008)
国家自然科学基金青年基金项目(81803295)
广西卫生健康委员会计划课题(Z20180300)
柳州市科学研究与技术开发计划课题(2017BH20304)。
