Singhi S, Dhawan A, Kataria S, Walia B N
Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Ann Trop Paediatr. 1994;14(1):53-8. doi: 10.1080/02724936.1994.11747692.
In a prospective study to determine simplified clinical signs predictive of pneumonia in children between 2 months and 5 years of age, and to test the validity of the signs recommended by the World Health Organization, clinical findings were correlated with X-ray evidence of pneumonia in 854 children, 400 with pneumonia and 454 with upper respiratory infections (no pneumonia). A respiratory rate of > or = 50/min in infants 2-6 months of age, > or = 40/min in children 7-35 months, and > or = 35/min in children > or = 36 months was the best discriminator of radiological evidence of pneumonia. Use of a respiratory rate of > or = 50/min instead of > or = 40/min resulted in a 14%, 19% and 32% loss of sensitivity with little gain in specificity in the age groups 7-11 months, 12-35 months and > or = 36 months, respectively. The age-specific respiratory rate (recommended by WHO) and/or chest indrawing, history of rapid or difficult breathing and/or chest indrawing, and nasal flaring were also sensitive and specific indicators of pneumonia in almost all the age groups studied.
在一项前瞻性研究中，为了确定2个月至5岁儿童肺炎的简化临床体征，并检验世界卫生组织推荐体征的有效性，对854名儿童的临床检查结果与肺炎的X线证据进行了相关性分析，其中400名患有肺炎，454名患有上呼吸道感染（无肺炎）。2至6个月婴儿呼吸频率≥50次/分钟、7至35个月儿童呼吸频率≥40次/分钟、36个月及以上儿童呼吸频率≥35次/分钟是肺炎放射学证据的最佳鉴别指标。在7至11个月、12至35个月和36个月及以上年龄组中，使用呼吸频率≥50次/分钟而非≥40次/分钟分别导致敏感性降低14%、19%和32%，而特异性几乎没有增加。年龄特异性呼吸频率（世卫组织推荐）和/或胸凹陷、呼吸急促或困难史和/或胸凹陷以及鼻翼扇动在几乎所有研究的年龄组中也是肺炎的敏感和特异指标。
