急性脑卒中合并院内获得性肺炎患者影响预后的危险因素分析

Risk Factors Affecting Prognosis of Patients with Acute Stroke Complicated Hospital-acquired Pneumonia

目的:分析急性脑卒中患者合并院内获得性肺炎(HAP)患者的危险因素及其与预后的相关性。方法:回顾性分析98例急性脑卒中患者,依据是否合并HAP分为:研究组(合并HAP)和对照组(未合并HAP)各49例。分析2组的年龄、收缩压(SP)、舒张压(DP)、血胆固醇(CHOL)水平、糖化血红蛋白(HbA1c)、中国脑卒中临床神经功能缺损程度评分(CSS)、反复唾液吞咽测试次数及耐甲氧西林金葡菌(MRSA)感染率、铜绿色假单胞菌(PA)感染率、白色念珠菌(CA)感染率与随访1年后生活自理能力评分(BI)的相关性,并比较2组BI、再出血率及病死率。结果:2组的年龄、CSS评分、反复唾液吞咽测试次数、SP、DP、HbA1c、MRSA感染率、PA感染率、CA感染率均与BI值呈独立相关,而CHOL则无明显相关。2组的BI、再出血率、病死率都存在统计学差异(P<0.05)。结论:急性脑卒中合并HAP患者影响预后的危险因素有年龄、CSS评分、吞咽功能、SP、DP、HbA1c、MRSA感染率、PA感染率、CA感染率。

Objective： To analysis the risk factors affecting prognosis of patients with acute stroke complicated hospital-acquired pneumonia（HAP）.Methods： Ninty-eight patients with acute strokes in our hospital were collected and divided into research and control groups,with 49 patients in each group,according to complicated HAP.The factors including age,systolic pressure（SP）,diastolic pressure（DP）,glycolated hemoglobin（HbA1c）,blood cholesterol（CHOL）,Chinese stroke scale scores（CSS）,repeat swallow test frequency,methicillin-resistant staphylococcus aureus（MRSA） infection rate and pseudomonas aeruginosa（PA） infection rate,Candida albicans（CA） infection rate in each group were isolated and analyzed.The association of these factors with Barthel index（BI） at 1 year after strokes was investigated.The BI,recurrence rate and mortality rate were compared between the two groups.Results： The age of onset,CSS,SP,DP,HbA1c,CA infection rate,MRSA infection rate,PA infection rate were negatively correlated with BI,whereas the repeat swallow test frequency was positively correlated with BI.The CHOL had no correlation with BI.BI,recurrence rate and mortality rate were significantly different between the two groups（P0.05）.Conclusion： The risk factors affecting the prognosis of patients with acute stroke complicated HAP are age,CSS,swallow function,SP,DP,HbA1c,MRSA infection rate,PA infection rate,and CA infection rate.