外周血炎症标志物对急性缺血性脑卒中患者相关性肺炎的预测价值  

Predictive Value of Peripheral Blood Inflammatory Markers for Pneumonia Associated in Patients with Acute Ischemic Stroke

作　　者：苏宁 晏子俊[2] 邹燕 余婷 张良明[2] SU Ning;YAN Zijun;ZOU Yan(School of Pharmacy,Dali University,Dali City,Yunnan Province 671000;不详)

机构地区：[1]大理大学药学院,云南省大理市671000 [2]四川省攀枝花市中心医院药学部

出　　处：《医学理论与实践》2025年第8期1272-1275,共4页The Journal of Medical Theory and Practice

基　　金：国家卫生健康委医院管理研究所2024年医疗质量(循证)管理研究项目(YLZLXZ24G039);中国药学会科普研究重点项目;四川省医院协会青年药师科研专项资金项目(22009);攀枝花市科学技术局项目(2024ZD-S-28);攀枝花市统计学会(2024pzh22);攀枝花市中心医院院内课题(202311)。

摘　　要：目的:探讨外周血炎症标志物对老年急性缺血性脑卒中(AIS)患者卒中相关性肺炎(SAP)的预测价值。方法:回顾性纳入攀枝花市中心医院神经内科2023年1—12月收治的278例老年AIS患者,根据是否发生SAP分为SAP组63例(22.66%),非SAP组215例(77.34%),采用多因素logistic回归分析SAP的危险因素,通过ROC曲线评估系统全身性炎症综合指数(AISI)及联合年龄、住院时间、血尿素氮对SAP的预测效能。结果:SAP组患者的年龄、住院时间、甘油三酯、同型半胱氨酸、尿素氮、肌酐、白细胞、中性粒细胞、淋巴细胞、单核细胞、血小板、SII、SIRI、AISI、NLR、PLR、MLR水平显著高于非SAP组(P<0.05);其中高龄、住院时间、高血尿素氮和高AISI水平是SAP的重要危险因素(P<0.05),AISI单独及分别联合年龄、住院时间、血尿素氮,以及四者联合均可有效预测老年AIS患者SAP的发生(P<0.05),曲线下面积(AUC)分别为0.830、0.851、0.840、0.844、0.889。结论:AISI可有效预测SAP的发生,其中AISI与年龄、住院时间、血尿素氮四者联合的预测效能最高。Objective:To investigate the predictive value of peripheral blood inflammatory markers for stroke-associated pneumonia(SAP)in elderly patients with acute ischemic stroke(AIS).Methods:We conducted a retrospective analysis of 278 elderly AIS patients admitted to the neurology department at Panzhihua central hospital from January 2023 to December 2023.The cohort was divided based on SAP occurrence into a SAP group(63 patients,22.66%)and a non-SAP group(215 patients,77.34%).Multivariate logistic regression was used to identify risk factors for SAP.The predictive performance of the aggregate index of systemic inflammation(AISI),both independently and in combination with age,length of hospital stay,and blood urea nitrogen(BUN),was assessed using receiver operating characteristic(ROC)curves.Results:Compared to the non-SAP group,patients in the SAP group exhibited significantly higher levels of age,length of hospital stay,triglycerides,homocysteine,BUN,creatinine,white blood cells,neutrophils,lymphocytes,monocytes,platelets,systemic immune-inflammation index(SII),systemic inflammation response index(SIRI),AISI,neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and monocyte-to-lymphocyte ratio(MLR)(all P<0.05).Among these,advanced age,prolonged hospitalization,elevated BUN,and increased AISI were identified as key risk factors for SAP(all P<0.05).AISI alone,as well as in combination with age,length of hospital stay,and BUN,effectively predicted SAP occurrence(all P<0.05),with respective area under the curve(AUC)values of 0.830,0.851,0.840,0.844,and 0.889.Conclusion:AISI is an effective predictor of SAP in elderly AIS patients,with the highest predictive accuracy achieved when combined with age,length of hospital stay,and BUN.

关 键 词：急性缺血性脑卒中 卒中相关性肺炎 外周血炎症标志物 全身性炎症综合指数 预测价值 

分 类 号：R446[医药卫生—诊断学]