急性卒中后肺炎的早期风险识别和预防

The Early Identification and Prevention of Acute Post-stroke Pneumonia Patients at High Risk

急性卒中后肺炎是卒中患者最主要的严重并发症之一,是卒中患者不良预后和死亡的最重要原因。了解急性卒中后肺炎的危险因素和预测卒中后感染发生的免疫功能标记物有利于早期识别急性卒中后肺炎高危患者。卒中诱发的免疫抑制综合症(stroke-induced immunodepression system,SIDS)的相关研究为临床预防急性卒中后感染开创了新的方向。为了论证预防性抗菌治疗(preventiveantibacterial therapy,PAT)是否对急性卒中后感染有积极的预防作用,还需要进行更多的试验。采取综合性干预措施,如执行卒中临床医疗途径及卒中单元,可能是目前减少急性卒中后肺炎发生、促进卒中患者康复的合适选择。

Acute post-stroke pneumonia is one of the most serious complications in stroke patients, and it is the most important cause of bad prognosis and death for acute stroke patients. Understanding its risk factors and immunity function markers for its prediction will be in favor of the early identification of high risk patients with acute post-stroke pneumonia. The study of Stroke- Induced Immunodepression System（SIDS） points out a new direction for prevention of the infection after acute stroke in clinical. In order to demonstrate the active preventive effects of Preventive Antibacterial Therapy （PAT）, more experiments is needed. Currently, comprehensive intervention measures, such as clinical pathway for stroke patients and stroke unit, may be the right choice for decreasing the occurrence of acute post-stroke pneumonia and promotion of stroke patients recovery.