摘要
目的探讨卒中相关性肺炎患者的临床特征和相关危险因素。方法采用回顾性研究方法,选择2010年1月至2014年12月中山大学附属第一医院神经科收治的卒中并发肺炎患者(247例)纳入肺炎组,并随机选择同期神经科住院的卒中未并发肺炎患者(247例)纳入对照组。运用描述性统计分析比较两组患者的临床特征和实验指标检查结果,对卒中相关性肺炎的相关危险因素进行Logistic回归分析。结果两组年龄[(71.30±13.00)岁vs.(61.25±14.5)岁]、吞咽困难[92(37.25%)vs. 30(12.15%)]、胃管进食[177(71.66%)vs. 21(8.50%)]、右侧大脑半球卒中[133(53.85%)vs. 97(39.27%)]、房颤病史[50(20.24%)vs. 19(7.69%)]、住院天数[(17.78±11.62)d vs.(12.89±5.87)d]、出院死亡[24(9.72%)vs. 3(1.21%)]、卒中病史[31(12.55%)vs. 48(19.43%)]、意识水平(GCSS)[(9.41±3.70)vs.(13.07±1.64)]比较差异有统计学意义(P<0.05);白细胞[(10.36±3.78)×109/L vs.(7.74±2.26)×109/L]、中性粒细胞百分比[(0.76±0.12)vs.(0.65±0.11)]、血肌酐[(107.55±11.60)μmol/L vs.(80.96±45.00)μmol/L]、淋巴细胞百分比[(0.16±0.10)vs.(0.25±0.10)]水平差异亦有统计学意义(P<0.05)。多因素Logistics回归分析显示,高龄(≥75岁)、胃管进食、吞咽障碍、意识障碍(GCSS评分3～8分、9～12分)、右侧大脑半球卒中和白细胞水平升高与卒中相关性肺炎密切相关。结论卒中相关性肺炎的独立危险因素主要是高龄(≥75岁)、胃管进食、吞咽障碍、意识障碍(重度GCSS评分3～8分、中度9～12分)、右侧大脑半球卒中和白细胞水平升高,临床应高度重视。
Objective To observe the clinical characteristics and risk factors in patients of stroke associated pneumonia.Methods 247 stroke associated pneumonia(SAP) patients that continuity hospiyalized from January 2010 to December2014 in the Neurology Department of the First Affiliated Hospital of Sun yatsen University were selected as case group;same number patients of non-pneumonia after stroke were randomly selected as control group. Descriptive statistics was used to analyze the clinical characteristics in both groups, and Logistic regression analysis were used to analyze the related factors of SAP. Results There was obvious difference of age [(71.30 ± 13.00) years vs.(61.25 ± 14.50) years],dysphagia [92(37.25%) vs. 30( 12.15%)], gastric tube feeding [177( 71.66%)vs. 21( 8.50%)], the right cerebral hemisphere stroke [133(53.85%) vs. 97(39.27%)], atrial fibrillation [50(20.24%) vs. 19(7.69%)], hospital stays [( 17.78±11.62)d vs.( 12.89±5.87) d], die at discharge [24(9.72%) vs. 3( 1.21%)], stroke history [31((12.55%)vs.48 (19.43%)],level ofconsciousness [GCSS (9.41±3.70)vs.GCSS (13.07±1.64)]between pneumonia and non-pneumonia groups (P<0.05). There was obvious differences of the levels of WBC [(10.36±3.78 )×10^9/L vs.(7.74±2.26)×10^9/L ],neutrophils percentage [(0.76±0.12) vs.(0.65±0.11 )],creatinine [(107.55±11.60)μmol/L vs.(80.96±45.00)μmol/L ],lymphoeytes percentage [(0.16±0.10)vs.(0.25±0.10)]between pneumonia and non-pneumonia groups (P<0.05).Multivariate logistic regression analysis shows that GCSS between 3-8 score and 9-12 score,advanced age (≥75 years),gastric tube feeding,dysphagia, the right cerebral hemisphere stroke,WBC level increase were closely related with SAP.Conclusions Advanced age(≥75 years),gastric tube feeding,dysphagia,disturbance of consciousness,the right cerebral hemisphere stroke,WBC level increase were independent risk factors of SAP.Clinically encountered such high-risk patients should be highly attended.
作者
肖孝勇
黄振华
刘志豪
古钎林
廖瑾莉
徐嘉
熊艳
詹红
杨震
XIAO Xiao-yong;HUANG Zhen-hua;LIU Zhi-hao;GU Qian-lin;LIAO Jin-li;XU Jia;XIONG Yan;ZHAN Hong;YANG Zhen(Second People's Hospital of Shenzhen,Shenzhen,Guangdong 518037;Emergency Department,the First Affiliated Hospital,Sun Yet-sen University,Guangzhou ,Guangdong 510080;Cardioloy Department,the First Affiliated Hospital, Sun Yet-sen University,Guangzhou ,Guangdong 510080,China)
出处
《热带医学杂志》
CAS
2019年第1期50-54,共5页
Journal of Tropical Medicine
基金
国家自然科学基金(81670220
31270992
30800215)
广东省自然科学基金(2014A030313086)
广东省科技计划项目(2015A020212013
2013B021800275)
中山大学青年教师培育项目(17ykzd18
13ykpy24)
广州市科技计划项目(201803010008)
广州经济技术开发区国际科技合作项目(2017GH13)
关键词
卒中相关性肺炎
临床特征
危险因素
Stroke associated pneumonia
Clinical characteristics
Risk factors
