首页 中华结核和呼吸杂志 2016年39卷4期 中国成人社区获得性肺炎诊断和治疗指南(2016年版)
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中国成人社区获得性肺炎诊断和治疗指南(2016年版)
中华医学会呼吸病学分会 
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DOI： 10.3760/cma.j.issn.1001-0939.2016.04.005
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摘要
本指南的适用范围：年龄18周岁及以上非免疫缺陷的社区获得性肺炎(community-acquired pneumonia, CAP)患者。
引用本文
中华医学会呼吸病学分会. 中国成人社区获得性肺炎诊断和治疗指南(2016年版)[J]. 中华结核和呼吸杂志,2016,39(4)：253-279.
DOI:10.3760/cma.j.issn.1001-0939.2016.04.005PERMISSIONS
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未经授权，不得转载、摘编本刊文章，不得使用本刊的版式设计。
除非特别声明，本刊刊出的所有文章不代表中华医学会和本刊编委会的观点。
本指南的适用范围：年龄18周岁及以上非免疫缺陷的社区获得性肺炎(community-acquired pneumonia, CAP)患者。
以下临床情况，本指南仅作参考，包括人免疫缺陷病毒(HIV)感染、粒细胞缺乏、血液系统肿瘤及实体肿瘤放化疗、器官移植、接受糖皮质激素及细胞因子拮抗剂治疗者罹患的肺炎。
本指南的修订方法：本指南由中华医学会呼吸病学分会感染学组牵头修订。经过3次现场工作会议和2次网络视频会议，确定了指南的整体框架和主要更新内容，并由方法学专家对所有参加指南编写的专家进行文献检索和证据等级评价的规范化培训。证据等级和推荐等级参照美国感染病学会/美国胸科学会2007年CAP指南
[
1
]。证据等级是对研究证据质量的评价，推荐等级是对一项干预措施利大于弊的确定程度的评价。一般来讲，证据等级越高，推荐等级也越高，但证据等级和推荐等级并不完全对应，还需要权衡患者意愿、价值观和资源消耗作出判断(
表1
)。
| 证据等级与推荐等级 | 说明 | |
|---|---|---|
| 证据等级 | ||
| 等级Ⅰ(高等级) | 高质量的随机对照临床研究(RCT)、权威指南以及高质量系统综述和荟萃分析 | |
| 等级Ⅱ(中等级) | 有一定研究局限性的RCT研究(如无隐蔽分组、未设盲、未报告失访)、队列研究、病例系列研究及病例对照研究 | |
| 等级Ⅲ(低等级) | 病例报道、专家意见及无临床资料的抗菌药物体外药敏研究 | |
| 推荐等级 | ||
| A(强推荐) | 该方案绝大多数患者、医生和政策制定者都会采纳 | |
| B(中度推荐) | 该方案多数人会采纳，但仍有部分人不采纳，要结合患者具体情况作出体现其价值观和意愿的决定 | |
| C(弱推荐) | 证据不足，需要患者、医生和政策制定者共同讨论决定 | |
展开表格
证据等级和推荐等级
指南内容分为8个部分，由核心成员带领8个小组，以统一标准查阅国内外文献、评价证据等级并完成初稿。推荐等级由指南全体编写成员投票决定。
初稿完成后，总执笔人负责汇总并修改，先后召开6次现场工作会议讨论修订稿，并先后3次征求中华医学会呼吸病学分会其他学组以及感染病学、临床微生物学、急诊医学、重症医学、临床药学等相关学科专家和美国、欧洲专家意见，根据讨论及反馈意见6次修改指南修订稿。
最终修改稿得到了全体执笔专家和咨询专家的同意。
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瞿介明，200025 上海交通大学医学院附属瑞金医院呼吸科，Email：
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