补体系统与卒中相关性肺炎的相关性分析  

Correlation of complement system with stroke-associated pneumonia

作　　者：张曦濛 张胜 黄适存[1] 杨翼[1] 徐敏[1] 薛群[1] 倪健强[1] ZHANG Xi-meng;ZHANG Sheng;HUANG Shi-cun;YANG Yi;XU Min;XUE Qun;NI Jian-qiang(Department of Neurology,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院神经内科,江苏苏州215006 [2]苏州大学附属第一医院医学检验中心,江苏苏州215006

出　　处：《中国实用内科杂志》2022年第2期142-145,共4页Chinese Journal of Practical Internal Medicine

基　　金：国家高技术研究发展计划(2017YFC0110304);江苏省高等学校自然科学研究项目(20KJB320021)。

摘　　要：目的研究补体系统(C3、C4、B因子)与卒中相关性肺炎(stroke associated pneumonia,SAP)的相关性。方法回顾性收集2018年7月至2019年7月于苏州大学附属第一医院神经内科住院的急性缺血性卒中患者294例。收集患者人口学特征及临床资料,测定患者发病48 h内血液C3、C4、B因子浓度。根据患者是否在病程中发生SAP将患者分为SAP组及非SAP组,采用非参数检验及logistic回归分析补体系统各成分与SAP的关系。结果SAP组患者年龄(P=0.000),心房颤动比例(P=0.000),心衰比例(P=0.011),国立卫生研究院卒中量表(NHISS)评分(P=0.000),B因子(P=0.001)浓度显著高于非SAP组。两组间C3,C4差异无统计学意义。年龄(P=0.017),NHISS评分(P=0.003),房颤(P=0.015),B因子(P=0.034)是SAP发生的独立危险因素。结论SAP组患者年龄、心房颤动比例、NHISS评分、血清B因子浓度显著高于非SAP组患者,可能为SAP发生的独立危险因素。早期高B因子血症可作为预测SAP发生的指标,B因子在SAP发生中的机制仍待进一步研究明确。Objective To investigate the relationship between the complement system(C3,C4 and complement factor B)and SAP(stroke-associated pneumonia).Methods A total of 294 patients with acute ischemic stroke were recruited from the Department of Neurology,First Affiliated Hospital of Soochow University from July 2018 to July 2019.Demographic characteristics and clinical data of the patients were collected.Concentrations of circulating C3,C4 and B factors of the patients were detected within 48 hours of onset.Patients were divided into SAP group and non-SAP group according to whether they had SAP during the course of stroke.Mann-Whitney U test and binary logistic regression were used to analyze the association of complement system with SAP.Results Age(P=0.000),prevalence of atrial fibrillation(P=0.000),prevalence of heart failure(P=0.011),NHISS score(P=0.000)and concentration of complement factor B(P=0.028)were significantly higher in SAP group than in non-SAP group.C3 and C4 showed no significant difference between the two groups.Age(P=0.017),NHISS score(P=0.003),atrial fibrillation(P=0.015)and complement factor B(P=0.034)were independent risk factors for SAP.Conclusion Age,NHISS score at stroke onset,prevalence of atrial fibrillation and concentration of complement factor B are significntly higher in SAP groop than in non-SAP group,and they may be independent risk factor of SAP.High concentration of circulating complement factor B at early stage of stroke was a potential indicator to predict SAP.The mechanism of complement factor B in the occurrence of SAP remains to be further studied and clarified.

关 键 词：急性缺血性脑卒中 卒中相关性肺炎 补体系统 B因子 

分 类 号：R743.3[医药卫生—神经病学与精神病学]