缺血性卒中相关性肺炎危险因素的病例对照研究  

A case-control study of risk factors for ischemic stroke-associated pneumonia

作　　者：王芳[1] 薛娟娟[2] 方建飞 尚淑玲[1] 张福青[2] WANG Fang;XUE Juan-juan;FANG Jian-fei;SHANG Shu-ling;ZHANG Fu-qing(Department of Neurology,Tangshan Union Medical College Hospital,Tangshan,Hebei 063000,China;不详)

机构地区：[1]唐山市协和医院神经内科,河北唐山063000 [2]天津医科大学第二医院神经内科,天津300211 [3]唐山市工人医院重症医学科

出　　处：《现代预防医学》2022年第12期2154-2158,共5页Modern Preventive Medicine

摘　　要：目的探讨缺血性卒中相关性肺炎的危险因素。方法回顾性纳入2018年1月—2020年12月期间唐山市协和医院神经内科住院的急性缺血性卒中(acute ischemic stroke,AIS)患者,收集人口统计学及临床资料。根据是否发生卒中相关性肺炎(stroke-associated pneumonia,SAP)分为非SAP组和SAP组,比较两组的各项临床资料,并采用多因素logistic回归分析SAP的独立影响因素。结果共纳入721例患者,平均年龄(65.63±12.07)岁;SAP组年龄、入院美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分,冠心病、心房颤动、卒中史、吞咽障碍和入院格拉斯哥昏迷评分≤10分的比例、同型半胱氨酸、纤维蛋白原和白细胞计数均高于非SAP组,而SAP组入院舒张压、高密度脂蛋白胆固醇、白蛋白、白蛋白与球蛋白比值、血红蛋白和红细胞计数均低于非SAP组,差异均有统计学意义;多因素logistic回归分析显示,年龄增高(OR=1.055,95%CI:1.009~1.103)、入院NIHSS评分增加(OR=1.290,95%CI:1.154~1.444)、白细胞计数升高(OR=1.267,95%CI:1.101~1.457)是SAP发生的危险因素。结论缺血性卒中相关性肺炎与高龄、入院NIHSS评分增加和白细胞计数升高相关。Objective To investigate the risk factors of ischemic stroke-associated pneumonia.Methods Patients with acute ischemic stroke(AIS)who were admitted to the Department of Neurology of Tangshan Union Hospital between January 2018 and December 2020 were retrospectively included,and demographic and clinical data were collected.The patients were divided into stroke-associated pneumonia(SAP)group and non-SAP group according to the occurrence of SAP,and the clinical data of the two groups were compared.Results A total of 721 patients with a mean age of(65.63±12.07)years were included.In SAP group,age,admission National Institutes of Health Stroke Scale(NIHSS)score,coronary artery disease,atrial fibrillation,stroke history,dysphagia and admission Glasgow coma score≤10,homocysteine,fibrinogen and white blood cell count were higher than those in the non-SAP group.While admission diastolic blood pressure,HDL cholesterol,albumin,albumin to globulin ratio,hemoglobin and red blood cell count were lower in the SAP group than in the non-SAP group,all with statistically significant differences.Multifactorial logistic regression analysis showed that increased age(OR=1.055,95%CI:1.009-1.103),increased admission NIHSS score(OR=1.290,95%CI:1.154-1.444),and elevated white blood cell count(OR=1.267,95%CI:1.101-1.457)were risk factors for SAP.Conclusion SAP is associated with advanced age,increased NIHSS score on admission,and elevated leukocyte count.

关 键 词：卒中 脑缺血 卒中相关性肺炎 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]