摘要
目的总结重症社区获得性肺炎（SCAP）患者的临床表现、病原学及预后影响因素。方法回顾性分析2002年至2006年我院重症监护室收治的成人SCAP患者的临床资料，比较存活组和死亡组临床特征的异同，建立多因素回归模型。结果82例SCAP患者入选，平均年龄（72±19）岁，死亡29例，病死率35．4％。84．1％的患者合并基础疾病，64例（78．0％）患者在Fine危险分级IV～V级，致病菌中最多见的是流感嗜血杆菌和肺炎链球菌。多因素回归分析表明多肺叶或双肺病变和发生休克是SCAP患者死亡的独立危险因素。结论SCAP患者发病率高、预后差，临床表现、病原学具有其特殊性，应给予足够重视。
Objective To describes the clinical picture and prognostic factors of adult patients admitted tO the intensive care unit for severe community - acquired pneumonia（SCAP）. Methods The clinical characteristics, aetiology and evolution of patients with SCAP admitted to our hospital between 2002 and 2006 were analyzed retrospectively. Univariate and multiple logistic regression analysis were used for statistical analysis. Results A total of 82 patients were included with a mean age of （72 ±19） years. There were 53 survivors and 29 death, and in - hospital mortality was 35.4%. The most frequent pathogen was haemophilus infiuenzae and streptococcus pneumoniae. In multivariate analysis the prognostic factors in- dependently associated with in - hospital mortality were altered rnuhilobar or bilateral involvement （ OR = 7.9, 95% CI ： 3.8 - 29.2, P 〈 0.01 ） and development of shock （ OR = 5.2,95% CI ： 1.4 - 20. 1, P = 0.01 ）. Conclusions The results of this study may aid in the management of empiric treatment in patients with SCAP and the patients who have a greater probability of bad evolution may be identified based on the risk factors.
出处
《中国实用医刊》
2009年第24期27-29,共3页
Chinese Journal of Practical Medicine
