脑卒中相关性肺炎的危险因素及血浆肝素结合蛋白水平对其预测价值  

Risk Factors of Stroke-associated Pneumonia and the Predictive value of the Level of Plasma Heparin-binding Protein

作　　者：马玉静 张伟[2] 袁欣 MA Yu-jing;ZHANG Wei;YUAN Xin(Department of Emergency,the Second Central Hospital of Baoding City,Zhuozhou,Hebei 072750,China;Department of Hemodialysis Room,the Second Central Hospital of Baoding City,Zhuozhou,Hebei 072750,China;Department of Internal Medicine,Hebei Youai Hospital,Shijiazhuang 050000,China)

机构地区：[1]保定市第二中心医院急诊科,河北涿州072750 [2]保定市第二中心医院血透室,河北涿州072750 [3]河北友爱医院内科,石家庄050000

出　　处：《解放军医药杂志》2022年第6期92-95,99,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省中医药管理局项目(2019493)。

摘　　要：目的探究脑卒中相关性肺炎(SAP)的危险因素及血浆肝素结合蛋白(HBP)水平对SAP的预测价值。方法回顾性分析2019年4月—2020年12月收治的重症脑卒中310例的临床资料,根据SAP诊断标准,将患者分为SAP组120例和非SAP组190例。比较2组性别、年龄、卒中类型、卒中部位、疾病史、吸烟史、饮酒史、吞咽障碍、气管插管/切开、药物使用史等情况及HBP水平;多因素Logistic回归分析重症脑卒中患者发生SAP危险因素,受试者工作特征曲线分析血浆HBP对SAP预测价值。结果年龄≥65岁、糖尿病史、慢性支气管炎、卒中史、吞咽障碍、气管插管/切开、使用质子泵抑制剂/H_(2)受体阻滞剂、使用预防性抗菌药物是脑卒中患者发生SAP的独立危险因素。SAP组HBP水平高于非SAP组(P<0.05)。血浆HBP对SAP预测的曲线下面积为0.927。当HBP水平>10.21μg/L时,其预测SAP的敏感度为90.00%,特异度为99.50%。结论SAP的危险因素较多,临床应采取相应措施控制危险因素。HBP水平对SAP预测价值较高。Objective To investigate the risk factors of stroke associated pneumonia(SAP)and the predictive value of plasma heparin binding protein(HBP)level in SAP.Methods Clinical data of 310 severe stroke patients admitted from April 2019 to December 2020 were retrospectively analyzed.According to SAP diagnostic criteria,patients were divided into SAP group(n=120)and non-SAP group(n=190).Gender,age,stroke type,stroke site,disease history,smoking history,drinking history,dysphagia,endotracheal intubation/incision,drug use history and the level of HBP were compared between the two groups.The risk factors of SAP were analyzed by Logistic regression analysis,and the predictive value of plasma HBP for SAP was analyzed by receiver operating characteristic(ROC)curve.Results Age≥65 years,history of diabetes,chronic bronchitis,history of stroke,dysphagia,tracheal intubation/incision,use of proton pump inhibitors/H_(2) receptor blockers,use of preventive antibacterial drugs were independent risk factors for SAP in stroke patients.The level of HBP in SAP group was higher than that in non-SAP group(P<0.05).The area under the ROC curve of plasma HBP in predicting SAP was 0.927.When the HBP level was higher than 10.21μg/L,the sensitivity of plasma HBP in predicting SAP was 90.00%and the specificity was 99.50%.Conclusion There are a variety of risk factors of SAP,and corresponding measures should be taken to control the risk factors in clinical practice.HBP level has a higher predictive value for SAP.

关 键 词：卒中 肺炎 肝素结合蛋白 危险因素 预测 

分 类 号：R743[医药卫生—神经病学与精神病学]