[1]袁明皓,张文玉,邹宁,等.急性脑梗死患者并发肺部感染的危险因素分析[J].第三军医大学学报,2019,41(02):153-157.
 YUAN Minghao,ZHANG Wenyu,ZOU Ning,et al.Risk factors for pulmonary infection in patients with acute cerebral infarction[J].J Third Mil Med Univ,2019,41(02):153-157.
点击复制

急性脑梗死患者并发肺部感染的危险因素分析(/HTML )
分享到:

《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
41卷
期数:
2019年第02期
页码:
153-157
栏目:
临床医学
出版日期:
2019-01-30

文章信息/Info

Title:
Risk factors for pulmonary infection in patients with acute cerebral infarction
作者:
袁明皓张文玉邹宁李琦秦新月
重庆医科大学附属第一医院神经内科
 
Author(s):
YUAN Minghao ZHANG Wenyu ZOU Ning LI Qi QIN Xinyue

Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 40016, China

关键词:
急性脑梗死肺部感染危险因素
Keywords:
acute cerebral infarction pulmonary infection risk factors
分类号:
R181.23; R563.1; R743.33
文献标志码:
A
摘要:

目的 研究急性脑梗死患者并发肺部感染的危险因素。方法 收集2017年4-12月重庆医科大学附属第一医院神经内科住院的急性脑梗死患者417例,对可能并发肺部感染的相关因素进行汇总,比较肺部感染组和非肺部感染组临床资料的差异,并进行多因素Logistic回归分析。结果 肺部感染组(n=92)与非肺部感染组(n=325)比较,年龄、性别、住院天数、吸烟、既往肺部疾病史、冠心病、高血脂、吞咽困难、入院时意识障碍、完全卧床、侵入性操作、入院时美国国立卫生院神经功能缺损评分(National Institutes of Health stroke scale score, NIHSS)、入院时改良RANKIN量表评分(modified rankin scale score, MRS)差异均具有统计学意义(P<0.05)。多因素Logistic回归分析示:入院时NIHSS评分>14分、年龄>65岁、侵入性操作、完全卧床是急性脑梗死患者并发肺部感染的危险因素(OR=5.410、2.714、21.823、3.013,95%CI:1.835~15.953、1.257~5.587、10.265~46.393、1.365~6.651,P均<0.05)。结论 入院时NIHSS评分、年龄、侵入性操作、完全卧床可作为防治急性脑梗死后并发肺部感染的参考指标。
 

Abstract:

Objective To explore the risk factors of pulmonary infection in patients with acute cerebral infarction. Methods We retrospectively reviewed the clinical data of 417 patients admitted for acute cerebral infarction in our hospital between April and December, 2017. We compared the data between the patients with and without pulmonary infection, and analyzed the risk factors for pulmonary infection following acute cerebral infarction using multiple logistic regression analysis. Results There were significant differences in age, gender, length of hospital stay, smoking, history of previous lung disease, coronary heart disease, hyperlipidemia, dysphagia, consciousness disturbance at admission, complete bed rest, invasive operation, National Institutes of Health Stroke Scale (NIHSS) score and Modified Rankin Scale (MRS) score at admission between the pulmonary infection group(n=92) and the non-pulmonary infection group(n=325)(P<0.05). Multiple logistic regression analysis suggested that NIHSS score>14 at admission, age>65 years, invasive operation, and complete bed rest were risk factors for pulmonary infection in patients with acute cerebral infarction(OR=5.410,2.714,21.823,3.013,95%CI:1.835~15.953,1.257~5.587,10.265~46.393,1.365~6.651,all P<0.05). Conclusion NIHSS score at admission, age, invasive operation and complete bed rest may be regarded as reference indexes in the prevention and treatment of pulmonary infection after acute cerebral infarction.

参考文献/References:

[1]LOZANO R, NAGHAVI M, FOREMAN K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010[J]. Lancet, 2012, 380(9859): 2095-2128. DOI: 10.1016/S0140-6736(12)617280.
[2]WINKLEWSKI P J, RADKOWSKI M, DEMKOW U. Crosstalk between the inflammatory response, sympathetic activation and pulmonary infection in the ischemic stroke[J]. J Neuroinflamm, 2014,11: 213. DOI: 10.1186/s12974-014-0213-4.
[3]SHI K, WOOD K, SHI F D, et al. Strokeinduced immunosuppression and poststroke infection[J]. Stroke Vasc Neurol, 2018, 3(1): 34-41. DOI: 10.1136/svn2017000123.
[4]Liu L, Xiong X Y, Zhang Q, et al. The efficacy of prophylactic antibiotics on poststroke infections: an updated systematic review and metaanalysis[J]. Sci Rep, 2016, 6: 36656. DOI: 10.1038/srep36656.
[5]ZHENG F, SPRECKELSEN N V, ZHANG X, et al. Should preventive antibiotics be used in patients with acute stroke? A systematic review and metaanalysis of randomized controlled trials[J]. PLoS ONE, 2017, 12(10): e0186607. DOI: 10.1371/journal.pone.0186607.
[6]刘鸣,蒲传强. 中国急性缺血性脑卒中诊治指南2014[J]. 中华神经科杂志, 2015, 48(4): 246-257. DOI: 10.3760/cma.j.issn.1006-7876.2015.04.002.
LIU M, PU C Q. Guidelines for the diagnosis and treatment of acute ischemic stroke in China in 2014 [J]. Chin J Neurol, 2015, 48(4): 246-257. DOI: 10.3760/cma.j.issn.1006-7876.2015.04.002.
[7]陆茸, 贡换龙, 马莹,等. 神经外科患者合并肺部感染临床特征分析[J]. 中国医药导刊, 2014(3): 412-413,415.
LU R, GONG H L, MA Y, et al. Related factors and prevention of lower respiratory tract infection in traumatic brain injury [J]. Chin J Med Guide, 2014(3): 412-413,415.
[8]张道松, 秦天成. 老年急性脑梗死伴发肺部感染36例危险因素分析[J]. 中国社区医师, 2017, 33(20): 78-79. DOI: 10.3969/j.issn.1007-614x.2017.20.47.
ZHANG D S, QIN T C. Risk factors of pulmonary infection in elderly patients with acute cerebral infarction:an analysis of 36 cases [J]. Chin Community Doct, 2017, 33(20): 78-79. DOI: 10.3969/j.issn.1007-614x.2017.20.47.
[9]张丽仙. 急性脑梗死患者并发肺部感染的影响因素分析[J]. 内蒙古医学杂志, 2015, 47(11): 1366-1367. DOI: 10.16096/J.cnki.nmgyxzz.2015.47.11.037.
ZHANG L X. Analysis of the influencing factors of pulmonary infection in patients with acute cerebral infarction[J]. Inner Mongofia Med J, 2015, 47(11): 1366-1367. DOI: 10.16096/J.cnki.nmgyxzz.2015.47.11.037.
[10]门中华. 急性脑卒中合并肺部感染相关因素及对预后的影响[J]. 中华医院感染学杂志, 2012, 22(10): 2053-2055.
MEN Z H. Risk factors for pulmonary infections in patients with acute cerebral apoplexy and influence on prognosis[J]. Chin J Nosocomiol, 2012, 22(10): 2053-2055.
[11]苏灵芝. 脑卒中患者并发肺部感染相关因素分析[J]. 包头医学院学报, 2009, 25(5): 62-63. DOI: 10.3969/j.issn.1006-740X.2009.05.028.
SU L Z. Analysis of related factors of pulmonary infection in stroke patients[J]. J Baotou Med Coll, 2009, 25(5): 62-63. DOI: 10.3969/j.issn.1006-740X.2009.05.028.
[12]许丽娜, 贾龙斌, 郭嘉英,等. 急性脑血管疾病并发肺部感染患者的临床特点研究[J]. 中华医院感染学杂志, 2017(19): 4405-4408. DOI: 10.11816/cn.ni.2017-170553.
XU L N,JIA L B,GUO J Y,et al. Clinical characteristics of acute cerebrovascular disease complicated with pulmonary infections [J]. Chin J Nosocomiol, 2017(19): 4405-4408. DOI: 10.11816/cn.ni.2017-170553.
[13]徐春华, 姜宇. 急性脑血管病并发肺部感染的防治策略[J]. 中国医药指南, 2011, 9(32): 109-110. DOI: 10.3969/j.issn.1671-8194.2011.32.082.
XU C H, JIANG Y. Prevention and treatment of acute cerebrovascular disease complicated with pulmonary infection[J]. Guide Chin Med, 2011, 09(32): 109-110. DOI: 10.3969/j.issn.1671-8194.2011.32.082.
[14]余永程, 郑江环, 杨华荣,等. NICU患者并发肺部感染的危险因素分析[J]. 中华医院感染学杂志, 2013, 23(7): 1538-1539,1552.
YU Y C, ZHENG J H, YANG H R, et al. Risk factors of pulmonary infections in NICU patients [J]. Chin J Nosocomiol, 2013, 23(7): 1538-1539.
[15]冯鑫. 老年急性脑梗死合并肺部感染患者危险因素和预后相关研究[J]. 中国保健营养, 2017, 27(5): 282-283.
FENG X. Risk factors and prognosis in elderly patients with acute cerebral infarction complicated with pulmonary infection[J]. China Health Nutr, 2017, 27(5): 282-283.
[16]ZHANG X, YU S, WEI L, et al. The A2DS2 score as a predictor of pneumonia and in-hospital death after acute ischemic stroke in chinese populations[J]. PLoS ONE, 2016, 11(3): e0150298. DOI: 10.1371/journal.pone.0150298.
[17]ASHOUR W, ALANWAR A D, KAMEL A E, et al. Predictors of early infection in cerebral ischemic stroke[J]. J Med Life, 2016, 9(2): 163-169.
[18]ARAI N, NAKAMIZO T, IHARA H, et al. Histamine H2blocker and proton pump inhibitor use and the risk of pneumonia in acute stroke: A retrospective analysis on susceptible patients[J]. PLoS ONE, 2017, 12(1): e0169300. DOI: 10.1371/journal.pone.0169300.
[19]HERZIG S J, DOUGHTY C, LAHOTI S, et al. Acidsuppressive medication use in acute stroke and hospital-acquired pneumonia[J]. Ann Neurol, 2014, 76(5): 712-718. DOI:10.1002/ana.24262.
[20]HO S W, HSIEH M J, YANG S F, et al. Risk of strokeassociated pneumonia with acid-suppressive drugs: A population-based cohort study[J]. Medicine (Baltimore), 2015, 94(29): e1227. DOI:10.1097/MD.000000000 0001227.
 

相似文献/References:

[1]王红梅,廖国清,雷红,等.晚期肺癌患者肺部感染病原学分析[J].第三军医大学学报,2006,28(20):2103.
[2]李军梅,刘刚,杨和平,等.3种碳青霉烯抗生素体外抗菌活性及对肺部感染的疗效观察[J].第三军医大学学报,2005,27(13):1391.
[3]童瑾,王导新.可溶性髓样细胞触发受体-1在肺部感染患者机械通气前后的动态变化及意义[J].第三军医大学学报,2010,32(15):1678.
[4]赵重庆,魏新亭.58例神经外科昏迷患者肺部感染病原学分析及治疗[J].第三军医大学学报,2010,32(23):2572.
[5]犹春跃,张平,赵洪新,等.脑梗死院内肺部感染临床分析[J].第三军医大学学报,2013,35(17):1857.
[6]梅春霞,刘娟,徐智,等.APACHEⅡ评分和降钙素原对肺部感染预后的预测作用[J].第三军医大学学报,2014,36(08):802.
 Mei Chunxia,Liu Juan,Xu Zhi,et al.Predictive value of APACHE Ⅱ score and procalcitonin in prognosis of patients with pulmonary infection[J].J Third Mil Med Univ,2014,36(02):802.
[7]罗丽,杨帆.纤维支气管镜肺泡灌洗术在肾移植术后肺部感染病因诊断中的应用[J].第三军医大学学报,2005,27(01):90.
[8]董湘陵.利复星和头孢曲松治疗肺部感染70例[J].第三军医大学学报,2002,24(01):0.[doi:10.16016/j.1000-5404.2002.01.029 ]
[9]叶明福,龚茜芳.多发性硬化并发胸腔积液一例尸检报告[J].第三军医大学学报,1991,13(05):0.[doi:10.16016/j.1000-5404.1991.05.048 ]
[10]刘明政,荣新洲,肖光夏,等.烧伤肺部感染对粒细胞功能的影响[J].第三军医大学学报,1990,12(03):0.[doi:10.16016/j.1000-5404.1990.03.039 ]

更新日期/Last Update: 2019-01-30