卒中相关性肺炎的临床特点及预测因子

Clinical features and predictors of stroke-associated pneumonia

目的探讨卒中相关性肺炎的临床特点和预测因子。方法选择2011年9～12月在我科治疗的脑卒中患者143例作为研究对象,回顾性分析其临床资料,从患者的基础状态、与卒中相关的因素、入院后相关治疗、入院当日首次血清降钙素原(PCT)、C-反应蛋白(CRP)、临床肺部感染评分(CPIS)等方面探讨卒中相关性肺炎的临床特点和预测因子。结果年龄>70岁,既往有脑卒中病史,合并有糖尿病、缺血性心脏病,出血性脑卒中,小脑和脑干卒中,出现吞咽困难、昏迷,使用胃黏膜保护剂,预防性使用抗生素、气管侵入性操作均与卒中相关性肺炎有相关性,PCT、CRP和CPIS可以作为SAP的预测因子(P均<0.01)。结论临床治疗中,应尽量避免过多的或不必要的侵入性操作,入院时的PCT、CRP和CPIS可以作为SAP的预测因子。

Objective To discuss the clinical features and predictors of stroke-associated pneumonia （SAP）. Methods Selected 143 cases with stroke from Sep to Dec in 2011, clinical data were analyzed. Clinical features and predictors were discussed from standard basal state, stroke related factors, treatment, PCT,CRP and CPIS before treatment. Results Age over 70, stroke history, diabetes mellitus, ischemic heart disease, hemorrhagic stroke, cerebellum and brainstem stroke, dysphagia, coma, gastric mucous ulcer, antibiotics for prevention, tracheal invasive operation were correlated with SAP （P〈 0.01）. PCT,CRP and CPIS were predictors of SAP （P 〈 0.01）. Conclusion Tracheal invasive operation should be avoided in treatment. PCT,CRP and CPIS before treatment were predictors of SAP.