血清检测值对急性缺血性脑卒中伴吞咽障碍患者并发卒中相关性肺炎的预测价值  

Predictive Values of Serum Test Values in Stroke Associated Pneumonia in Acute Ischemic Stroke Patients with Swallowing Disorder

作　　者：庞婷婷 陈梓焜 李婧 胡跃强[1] 黎军宏 PANG Tingting;CHEN Zikun;LI Jing;HU Yueqiang;LI Junhong(The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530023,China;Guangxi University of Chinese Medicine,Nanning 530200,China;Guangxi Key Laboratory of Chinese Medicine Basic Research,Guangxi University of Chinese Medicine,Nanning 530200,China)

机构地区：[1]广西中医药大学第一附属医院,广西南宁530023 [2]广西中医药大学,广西南宁530200 [3]广西中医药大学广西中医基础研究重点实验室,广西南宁530200

出　　处：《西部中医药》2024年第2期157-161,共5页Western Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81874453);广西自然科学基金(2019GXNSFBA245091);广西科技计划项目(桂科AB18221020);广西中医基础研究重点实验室课题(K201255808);广西中医药大学2020年研究生教育创新计划项目(xjyb020144)。

摘　　要：目的:探究急性缺血性脑卒中(acute ischemic stroke,AIS)伴吞咽障碍(swallowing disorders,SD)患者的血清检测值对并发卒中相关性肺炎(stroke associated pneumonia,SAP)的预测价值,为减少卒中后并发症,提高患者生存质量,加快康复进程提供参考依据。方法:采集363例AIS合并SD患者的临床资料,其中SAP组47例,非SAP组316例。采用单因素和多因素Logistic回归分析方法,对患者的入院血清检测值进行回顾性分析,筛选卒中相关性肺炎发生的最佳预测值,建立受试者工作特征曲线评估并验证其预测性能。结果:单因素分析表明,SAP组中性粒细胞、中性粒细胞百分比、血小板、单核细胞、血小板压积、中性粒细胞/淋巴细胞比值、血红蛋白、红细胞比容等指标显著高于非SAP组(P<0.05);血糖、淋巴细胞与单核细胞比值显著低于非SAP组(P<0.05),发生意识障碍的人数和饮酒、吸烟人数多于非SAP组(P<0.05)。多因素Logistic回归分析显示,中性粒细胞、意识障碍、血糖是AIS合并SD患者发生SAP的独立危险因素(OR分别为1.26、6.71、0.936,P<0.01)。结论:中性粒细胞、意识障碍、血糖异常是SAP发生的独立危险因素,三因素综合分析有利于预测SAP的发生风险,可为临床工作者对患者进行病情评估,提前采取合理且具有针对性的防治措施提供参考。Objective:By exploring the predictive values of serum test values in acute ischemic stroke(AIS)patients with swallowing disorder(SD)on stroke associated pneumonia(SAP),to provide the reference for the reduction of poststroke complications,the improvement of the patients'quality of life and acceleration of rehabilitation.Methods:Clinical data of 363 cases of AIS complicated with SD were gathered,among them,47 cases in SAP group and 316 cases in non SAP group.Univariate and multivariate Logistic regression analysis were adopted to retrospectively analyze the admission serum test values,to screen the optimal predictive values for the occurrence of SAP,to build receiver operator characteristic(ROC)curve and to verify its predictive performance.Results:Univariate analysis showed that the indexes of neutrophile granulocyte,the percentage of the neutrophils,blood platelet,monocyte,platelet hematocrit,neutrophil/lymphocyte ratio,hemoglobin and hematocrit of SAP group were noticeably higher than these of non SAP group(P<0.05);blood glucose,lymphocyte to monocyte ratio remarkably lower than these of non SAP group(P<0.05);The number of people with consciousness disorders and number of people who consumed alcohol and smoked were more than these of non SAP group(P<0.05).Multivariate Logistic regression analysis displayed that neutrophile granulocyte,consciousness disorders and blood sugar are the independent risk factors for SAP in AIS patients with SD(OR was 1.26,6.71 and 0.936 respectively,P<0.01).Conclusion:Neutrophile granulocyte,consciousness disorders and blood sugar are the independent risk factors for the development of SAP,three-factor comprehensive analysis could help predict the risks in the development of SAP,which could provide the reference for clinical workers'evaluation of the patients'disease and taking the reasonable and targeted prevention and treatment measures.

关 键 词：脑卒中 缺血性 急性 吞咽障碍 肺炎 血清 预测价值 受试者工作特征曲线 

分 类 号：R255.2[医药卫生—中医内科学]