马达　　倪海滨　　张晓震

[摘要] 社区获得性肺炎（Community scquired pneumonia，CAP）临床较为常见，对CAP患者进行疾病严重程度分级评估是合理治疗的基础，尽早识别、全面评价CAP严重程度具有积极的临床意义。重症肺炎患者死亡率更高、住院费用更多，如何降低社区获得性肺炎的重症转化率、减轻患者经济负担是临床治疗常常要面对的难题。使用临床评分量表和（或）生物标志物对需要住院治疗或入住重症监护病房（Intensive care unit，ICU）的高危患者进行早期评估并积极干预有利于改善其生存率并实现社会资源的有效利用。本文针对近些年来不同评分量表及生物标志物在CAP患者病情中的评估作用进行了综述研究。

[关键词] 社区获得性肺炎;评分量表;生物标志物;预后;重症监护病房

[中图分类号] R563.1          [文献标识码] A          [文章编号] 1673-9701（2021）11-0188-05

Research progress of scoring scale and biomarkers in evaluating community-acquired pneumonia

MA Da1   NI Haibin2   ZHANG Xiaozhen2

1.The Third Clinical Medical College， Nanjing University of Chinese Medicine， Nanjing   210046， China; 2.Emergency Department， Affiliated Hospital of Integrated Traditional Chinese and Western Medicine， Nanjing University of Traditional Chinese Medicine， Nanjing   210028， China

[Abstract] Community-acquired pneumonia （CAP） is clinically common. Grading and evaluating the severity of disease in patients with CAP is the basis for reasonable treatment. Early identification and comprehensive evaluation of the severity of CAP has positive clinical significance. Patients with severe pneumonia have a higher mortality rate and more hospitalization costs. How to reduce the severe conversion rate of community-acquired pneumonia and the economic burden of patients is a difficult problem that clinical treatment often faces. The use of clinical scoring scales and/or biomarkers for early assessment and active intervention of high-risk patients who need to be hospitalized or admitted to an intensive care unit （Intensive care unit， ICU） will help improve their survival rate and achieve effective use of social resources. This article reviews the role of different scoring scales and biomarkers in evaluating the condition of CAP patients in recent years.

[Key words] Community-acquired pneumonia; Score scale; Biomarker; Prognosis; Intensive care unit

社區获得性肺炎（Community-acquired pneumonia，CAP）临床较为常见，多种病原体可以引起该疾病，比如肺炎链球菌、支原体、衣原体、病毒、真菌、金黄色葡萄球菌和其他一些革兰阴性细菌[1-2]。据统计，CAP的发病率为0.2%～3%，住院率为20%～60%[3]。由于某些病原体感染的CAP具有一定的传染性，可能造成疾病传播，故重症CAP已经成为世界上主要的死亡病因之一，已经给全世界的医疗体系带来了繁重的经济负担[4]。大量基于人口统计学的研究数据显示，有21%的肺炎患者必须进入重症监护病房（Intensive care unit，ICU）医治，其中6%的患者需要进行有创机械通气维持呼吸功能保证氧供，而2%的患者最终会因呼吸衰竭而死亡[5-7]。对于CAP患者来说，特别是在普通病房中，如果临床医生对其病情严重程度认识不足，有可能会导致治疗方法不当从而造成严重后果。……