急性脑梗死的体积及部位与脑卒中相关性肺炎的关系  

Relationship between the volume and location of acute cerebral infarct and stroke-associated pneumonia

作　　者：韩云飞[1,2] 惠康丽[1] 闫福岭[3] 

机构地区：[1]东南大学附属中大医院神经内科,210009 [2]南京军区南京总医院训练中心 [3]南京军区南京总医院麻醉科

出　　处：《临床神经病学杂志》2011年第3期177-179,共3页Journal of Clinical Neurology

基　　金：江苏省自然科学基金(BK2008299);卫生部科研课题(lw201007)

摘　　要：目的探讨急性脑梗死(ACI)的体积及部位与脑卒中相关性肺炎(SAP)的关系。方法分析281例ACI患者的梗死灶体积及部位与SAP的关系。结果 281例ACI患者根据其梗死灶体积分为微小病灶组(54例)、中等病灶组(127例)、大病灶组(61例)及超大病灶组(39例),SAP发生率分别为13.0%、11.0%、31.1%、61.5%,超大病灶组SAP的发生率明显高于其他3组(均P<0.01)。按梗死灶的部位分组的左半球组(97例)、右半球组(122例)和双侧病灶组(11例),SAP发生率分别为16.5%、24.6%、72.7%,双侧病灶组SAP发生率较单侧半球组明显增加(均P<0.05);皮质组(57例)、皮质下组(126例)、皮质+皮质下组(47例)SAP的发生率分别为16.3%、11.1%、53.2%,皮质+皮质下组SAP的发生率显著高于其他两组,并且皮质组显著高于皮质下组(均P<0.05);前循环组(161例)、后循环组(61例)、前+后循环组(59例)SAP的发生率分别为15.5%、19.7%、45.8%,前+后循环组SAP发生率较其他两组明显增高(均P<0.05)。结论大病灶脑梗死、皮质脑梗死、多发性脑梗死患者更容易发生SAP。Objective To investigate the relationship between the volume and location of acute cerebral infarct （ACI） and the stroke-associated pneumonia （SAP）. Methods The relationship between the the size and location of infarct lesion with SAP in 281 ACI patients were analyzed. Results According to the volume of infarct lesion, the 281 ACI patients were divided into the minute lesion group （54 cases）, medium lesion group （ 127 cases）, large lesion group （61 cases） and super large lesion group （39 cases）, and the SAP incidence in each group was 13.0%, 11. 0% , 3 1. 1%, 61.5 %, respectively. The SAP incidence in super large lesion group was significantly higher than the other 3 groups （all P 〈0. 01 ）. According to the location of the infarct lesion, the patients were divided into left hemisphere group （97 cases） ,right hemisphere group （ 122 cases） and double hemisphere group （ 11 cases） ; and the SAP incidence in each group was 16. 5% , 24. 6% , 72. 7% , respectively. The SAP incidence in double hemisphere group was significantly higher than the other 2 groups （ all P 〈 0. 05 ）. The SAP incidence in cortical group （57 cases）, subcortical group （126 cases）, cortical ＋ subcortical group （47 cases） was 16.3%, 11.1%, 53.2% , respectively. And which in cortical ＋ subcortical group was significantly higher than the other 2 groups （ all P 〈 0. 05）. The SAP incidence in anterior circulation group（ 161 cases）, posterior circulation group（61 cases） and anterior ＋ posterior circulation group （59 cases） was 15.5% , 19.7%, 45.8%, respectively. And which in anterior ＋ posterior circulation group was significantly higher than the other 2 groups （ all P 〈 0. 05 ）. Conclusion The ACI patients with large, cortical infarct lesion and multi infarct lesions are much easier suffer from SAP.

关 键 词：急性脑梗死 梗死灶体积、部位 脑卒中相关性肺炎 

分 类 号：R743.33[医药卫生—神经病学与精神病学]