老年男性卒中相关肺炎危险因素的临床研究  

Analysis of risk factors for stroke associated pneumonia in aged patients

作　　者：尚延昌[1] 王淑辉[2] 高中宝[1] 柏秀娟[1] 解恒革[1] 王振福[1] 吴卫平[1] 

机构地区：[1]解放军总医院南楼神经内科,北京100853 [2]首都医科大学附属北京友谊医院神经内科

出　　处：《中华保健医学杂志》2014年第4期276-279,共4页Chinese Journal of Health Care and Medicine

基　　金：解放军总医院临床科研扶持基金(2012FC-TSYS-3057);国家自然科学基金(81100237)

摘　　要：目的探讨老年保健人群卒中相关肺炎（SAP）的危险因素。方法采用回顾性调查方法,对2008年1月-2012年12月在解放军总医院老年神经内科住院,时间超过24 h的老年（60岁以上）男性SAP患者进行临床资料和血液生物学标记物的采集,应用单因素和多因素Logistic回归分析进行统计学分析。结果本研究共有101例老年男性卒中病例入选,其中35例患者合并SAP,SAP发生率为34.66%。重度神经功能障碍（P〈0.01,OR=202.69,95%CI=9.1598-4485.1646）、吞咽困难（P〈0.01,OR=12.9005,95%CI=2.6275-63.3385）、心房纤颤（P〈0.05,OR=5.5997,95%CI=1.1804-26.5636）、高C反应蛋白（P〈0.01,OR=12.3942,95%CI=3.2630-47.0782）、高糖化血红蛋白（P〈0.05,OR=1.7976,95%CI=1.0548-3.0635）水平均为SAP的独立危险因素。结论及早识别和评价SAP危险因素,对于预防和治疗老年SAP将起到非常重要的作用。Objective To evaluate risk factors for stroke associated pneumonia（SAP） in aged stroke patients. Methods This was a retrospective observational study of SAP patients admitted to hospitals between Jan 2008 and Dec 2012. The clinical data and plasma biomarkers levels were collected. The data were analyzed by multivariable logistic regression. Results One hundred and one aged male stroke patients were included in the present study and the incidence of SAP was 34.66%. The following independent risk factors for SAP were found：severe neurological impairment（P〈 0.01,OR = 202.69,95%CI = 9.1598 - 4485.1646）,dysphagia（P〈 0.01,OR = 12.9005,95%CI = 2.6275 - 63.3385）,and atrial fibrillation（P〈 0.05,OR = 5.5997,95%CI = 1.1804 - 26.5636）,higher levels of CRP（P〈 0.01,OR = 12.3942,95%CI = 3.2630 - 47.0782） and elevated glycosylated hemoglobin level（P〈 0.05,OR =1.7976,95% CI = 1.0548 - 3.0635）. Conclusion SAP is associated with severe neurological impairment,dysphasia,atrial fibrillation,higher levels of CRP and hemoglobin. Identification and evaluation of these risk factors can be used to identify patients at high risk of developing SAP.

关 键 词：老年人群 卒中相关肺炎 危险因素 

分 类 号：R563.1[医药卫生—呼吸系统]