低胆固醇血症在脑梗死合并肺部感染治疗中的影响  

Effect of hypocholesteremia in treatment of cerebral infarction complicated with pulmonary infection

作　　者：龙升华 柯正华[1] 赵俊[2] 

机构地区：[1]鄂东医疗集团黄石市中心医院呼吸内科,湖北黄石435000 [2]鄂东医疗集团黄石市中心医院老年病科,湖北黄石435000

出　　处：《临床肺科杂志》2017年第11期2016-2019,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的研究低胆固醇血症对脑梗死合并肺部感染患者病情严重程度及预后的影响。方法收集我院脑梗死合并肺部感染患者76例,根据血浆胆固醇水平分为低胆固醇组38例和对照组38例。记录所有患者入组时年龄、性别、吸烟史、脑梗死分期、NIHSS评分。留取患者清晨空腹血测定血C反应蛋白(C-reactive protein,CRP)。采用临床肺部感染评分(clinical pulmonary infection score,CPIS)、肺炎严重指数(pneumonia severity index,PSI)对肺部感染严重程度进行评分,并记录两组治疗期间的辅助通气发生人数、气管插管人数、28天死亡人数,进行两组之间的比较。结果两组患者在年龄、性别、吸烟史、脑梗死分期、NIHSS评分等一般资料比较差异无统计学意义(P>0.05)。低胆固醇组CRP(8.5±2.3mg/dl)较对照组(7.3±1.9 mg/dl)高,差异有统计学意义(P<0.05)。低胆固醇组CPIS评分(6.4±1.9分)、PSI评分(87.0±24.0分)均较对照组(5.4±2.0分,74.3±23.5分)高,且差异有统计学意义(P<0.05)。低胆固醇组在辅助通气发生率(28.9%)、气管插管率(26.3%)、28天病死率(21.1%)均较对照组(7.9%,7.9%,5.3%)高,且差异有统计学意义(P<0.05)。结论脑梗死合并肺部感染患者存在低胆固醇血症时肺部感染病情程度较无低胆固醇血症者重,预后差。Objective To study the effect of hypocholesteremia on the severity and prognosis of patients with cerebral infarction complicated with pulmonary infection. Methods 76 cases of cerebral infarction complicated with pulmonary infection in our hospital were divided into the hypocholesteremia group （n=38） and the control group （n=38） according to the plasma cholesterol level. Their age, sex, smoking history, cerebral infarction stage, and NIHSS score were recorded. The morning venous blood was collected to determine the level of CRP. Clinical pulmo-nary infection score （ CPIS） and pneumonia severity index （ PSI） were used to evaluate the severity of pulmonary in-fection. The number of auxiliary ventilation, tracheal intubation, and 28-day mortality were recorded during the treat-ment of the two groups. Results There was no significant difference in age, sex, smoking history, stage of cerebral infarction, or NIHSS score between the two groups （P〉0. 05）. The level of CRP was （8. 5 ± 2. 3 mg/dl） in the hy-pocholesteremia group and （7. 3 ± 1. 9 mg/dl） in the control group （P〈0. 05）. The CPIS score and PSI score in the hypocholesteremia group （6. 4 ± 1. 9 points and 87. 0 ± 24. 0 points） were significantly higher than the control group （5. 4 ±2. 0 points and 74. 3 ±23. 5 points） （P〈0. 05）. The incidence of assisted ventilation, tracheal intubation rate （ ） , and 28-day mortality （ ） in the hypocholesteremia group （ 28. 9%, 26. 3% and 21. 1%） were higher than those in the control group （7. 9%, 7. 9% and 5. 3%） （P〈0. 05）. Conclusion In patients with cerebral infarction complicated with pulmonary infection, hypocholesteremia has severe infection and the prognosis is poor.

关 键 词：低胆固醇血症 肺部感染 脑梗死 C反应蛋白 

分 类 号：R563.1[医药卫生—呼吸系统] R743.3[医药卫生—内科学]