摘要
目的:分析脑卒中后肺部感染患者炎症细胞因子、免疫功能变化及影响因素。方法:回顾性分析2018年8月-2020年8月佳木斯骨科医院收治的90例脑卒中患者(研究组)及50例同期健康体检者(对照组)的临床资料,脑卒中患者根据其是否发生肺部感染分为感染组(n=37)和非感染组(n=53)。比较感染组、未感染组及对照组血清降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素-6(IL-6)及T淋巴细胞亚群(CD3^(+)、CD3^(+)CD4^(+)、CD3^(+)CD8^(+)、CD4^(+)/CD8^(+))水平,采用logistic回归分析脑卒中患者发生肺部感染的影响因素。结果:三组血清PCT、CRP、IL-6及T淋巴细胞亚群水平比较,差异均有统计学意义(P<0.001);未感染组、感染组血清PCT、CRP、IL-6及CD3^(+)CD8^(+)水平均高于对照组,CD3^(+)、CD3^(+)CD4^(+)、CD4^(+)/CD8^(+)水平均低于对照组,且感染组较未感染组更显著,差异均有统计学意义(P<0.05);单因素分析结果显示,感染组与非感染组侵入性操作、意识障碍、吞咽障碍、合并糖尿病、卧床治疗时间、住院时间、CD4^(+)/CD8^(+)比较,差异均有统计学意义(P<0.05);logistic分析结果显示,合并糖尿病、侵入性操作、意识障碍及吞咽障碍、卧床治疗时间≥14 d、住院时间≥21 d、CD4^(+)/CD8^(+)<1.4均是脑卒中后继发肺部感染的危险因素(P<0.05)。结论:脑卒中患者炎症应激较强,且细胞免疫功能降低,根据继发肺部感染的危险因素采取相应预防措施,对控制感染有积极意义。
Objective:To analyze the changes of inflammatory cytokines and immune function and influencing factors of pulmonary infection in patients after stroke.Method:A retrospective analysis was performed on the clinical data of 90 patients with stroke(the study group)who were admitted to Jiamusi Orthopaedic Hospital and 50 healthy people(the control group)from August 2018 and August 2020.According to presence or absence of pulmonary infection,stroke patients were divided into infection group(n=37)and non-infection group(n=53).The levels of serum procalcitonin(PCT),C reactive protein(CRP),interleukin-6(IL-6)and T Lymphocyte subsets(CD3^(+),CD3^(+)CD4^(+),CD3^(+)CD8^(+),CD4^(+)/CD8^(+))among infection group,non-infection group and control group were compared.The influencing factors of pulmonary infection in stroke patients were analyzed by logistic regression analysis.Result:There were significant differences in levels of serum PCT,CRP,IL-6 and T lymphocyte subsets among three groups(P<0.001).The levels of serum PCT,CRP,IL-6 and CD3^(+)CD8^(+)in the non-infection group and the infection group were higher than those in the control group,while the levels of CD3^(+),CD3^(+)CD4^(+)and CD4^(+)/CD8^(+)were lower than those in the control group,the differences in the above indexes were more significan in infection group than those in the non-infection group,the differences were statistically significant(P<0.05).The results of univariate analysis showed that differences in invasive operation,disturbance of consciousness,dysphagia,diabetes,bed rest time,hospitalization time and CD4^(+)/CD8^(+)between infection group and non-infection group were statistically significant(P<0.05).The results of logistic analysis showed that diabetes,invasive operation,disturbance of consciousness,dysphagia,bed rest time≥14 d,hospitalization time≥21 d and CD4^(+)/CD8^(+)<1.4 were risk factors of pulmonary infection after stroke(P<0.05).Conclusion:Stroke patients have strong inflammatory stress and declined cellular immune function,taking corresponding preventive measures according to influence factors of pulmonary infection is of positive significance for infection control.
作者
王红
WANG Hong(Jiamusi Orthopaedic Hospital,Heilongjiang Province,Jiamusi 154002,China)
出处
《中国医学创新》
CAS
2022年第21期150-154,共5页
Medical Innovation of China
关键词
脑卒中
肺部感染
炎症因子
细胞免疫
危险因素
Stroke
Pulmonary infection
Inflammatory factor
Cellular immunity
Risk factor
