急性缺血性脑卒中相关性肺炎危险因素分析及急性缺血性脑卒中相关分析评分的预测价值  

Analysis of risk factors for acute ischemic stroke-associated pneumonia and the predictive value of AIS-APS score

作　　者：王萌 杜俊秋 WANG Meng;DU Junqiu(Huai’an Hospital,Xuzhou Medical University,Huai’an 223000,China)

机构地区：[1]徐州医科大学附属淮安医院,江苏淮安223000

出　　处：《陕西医学杂志》2025年第1期97-100,共4页Shaanxi Medical Journal

基　　金：江苏省卫生健康委员会科研项目(2023FS-1094)。

摘　　要：目的:探讨急性缺血性脑卒中(AIS)相关性肺炎(SAP)危险因素分析及急性缺血性脑卒中相关肺炎(AIS-APS)评分的预测价值研究。方法:选择160例AIS患者为研究对象,根据是否发生SAP感染分为SAP组(n=70)和非SAP组(n=90),分析AIS患者感染SAP的危险因素及多因素Logistic回归分析,收集AIS患者痰液标本,记录标本来源并进行菌种鉴定,用ROC曲线分析AIS-APS评分对AIS患者感染SAP的预测价值。结果:年龄、糖尿病、慢性阻塞性肺疾病、入院时美国国立卫生研究院卒中表(NIHSS)评分>8、AIS-APS评分是影响AIS患者发生SAP的危险因素(均P<0.05)。70例感染SAP患者共检测出病原菌85株,最多的是格兰阴性杆菌一共56株在其中占比65.88%,其次是格兰阳性菌一共16株占比18.82%,真菌一共13株占比为15.29%。ROC曲线分析显示,AIS-APS评分对AIS患者感染ASP的预测AUC为0.75,灵敏度为85.71%,特异度为74.29%(均P<0.05)。结论:年龄、糖尿病、慢性阻塞性肺疾病、入院时NIHSS评分>8、AIS-APS评分是影响AIS患者发生SAP的危险因素,AIS-APS评分是预测AIS患者感染SAP的有效工具。Objective:To investigate the risk factors analysis of acute ischemic stroke(AIS)associated pneumonia(SAP)and the predictive value of AIS-APS score.Methods:160 AIS patients were selected as the study objects,and divided into SAP group(n=70)and non-SAP group(n=90)according to whether SAP infection occurred.The risk factors of AIS patients with SAP infection and multi-factor Logistic regression analysis were analyzed,sputum samples of AIS patients were collected,specimen sources were recorded,and strains were identified.ROC curve was used to analyze the predictive value of AIS-APS score in AIS patients with SAP infection.Results:Age,diabetes mellitus,chronic obstructive pulmonary disease,NIHSS score>8 at admission and AIS-APS score were the risk factors for AIS patients with SAP(all P<0.05).A total of 85 strains of pathogenic bacteria were detected in 70 patients infected with SAP,of which 56 strains of Gram-negative bacteria accounted for 65.88%,followed by 16 strains of Gram-positive bacteria accounting for 18.82%,and 13 strains of fungi accounting for 15.29%.ROC curve analysis showed that AIS-APS score predicted ASP infection in AIS patients with AUC of 0.75,sensitivity of 85.71%,specificity of 74.29%(all P<0.05).Conclusion:Age,diabetes mellitus,chronic obstructive pulmonary disease,NIHSS score>8 at admission and AIS-APS score are risk factors affecting the occurrence of SAP in AIS patients.Ais-aps score is an effective tool for predicting SAP infection in AIS patients,and can be applied and promoted in clinical practice.

关 键 词：急性缺血性脑卒中 脑卒中相关性肺炎 危险因素 AIS-APS评分 预测价值 病原菌 

分 类 号：R743[医药卫生—神经病学与精神病学]