Kattalarda uchraydigan shifoxonadan tashqari pnevmoniyaning og’irlik darajani matematik modellash
Keywords:
shifoxonadan tashqari pnevmoniya, matematik model, korrelyatsiya, kogort, Fisher testiAbstract
Hozirgi kunda klinik amaliyotda S. pneumoniae va L. pneumophila serogruxlarni 1 (barcha Legionella infektsiyasining 70% holatlari uchun javobgar) antigenlarini aniqlash uchun testlar mavjud. Ushbu usullar birinchi marta 2007 yilda Amerika toraks jamiyati tomonidan shifoxonadan tashqari pnevmoniyaning mumkin bo’lgan etiologiyasini aniqlash va tegishli etiotropik terapiyani tayinlash uchun skrining vositasi sifatida tavsiya etilgan. Amalga oshirish qulayligi va etarlicha yuqori sezuvchanlik (50-80%) va o’ziga xoslik (90% dan ortiq) ushbu testlardan foydalanish qulayligini tezlik bilan ta’minlaydi. Mamlakatimizda ushbu ekspress diagnostika usullari nisbatan yaqinda ro’yxatga olingan va hozirgacha ulardan foydalanish alohida klinik markazlardan tashqariga chiqmagan. Yaqinda tibbiy yordam bilan bog’liq pnevmoniya (healthcare-associated pneumonia) tobora ko’proq izolyatsiya qilingan. Ushbu turkumda qariyalar uylarida yoki boshqa uzoq muddatli parvarishlash muassasalarida bo’lgan shaxslarda pnevmoniyani o’z ichiga oladi; so’nggi uch oy ichida oldingi antimikrobiyal terapiya tarixi yoki so’nggi 90 kun ichida ikki kundan ortiq kasalxonaga yotqizilganda. Kelib chiqish shartlariga ko’ra, bunday pnevmoniya shifoxona sifatida qaraladi. Biroq, ular patogenlarning tarkibi va ularning antibiotik qarshiligi profilida farq qilishi mumkin. Zamonaviy qo’llanmalar "atipik pnevmoniya" atamasidan uzoqlashishni va "atipik patogenlar oqibatida pnevmoniya" tushunchasini qo’llashni taklif qiladi, chunki shifoxonadan tashqari pnevmoniyaning tabiatini to’liq aniqlash mumkin emas.
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