并发肺部感染缺血性脑卒中患者临床及中医特征分析

An Analysis of Characteristics for Patients with Cerebral Infarction Complicated with Pulmonary Infections in Clinical and TCM

目的:探讨并发肺部感染的缺血性脑卒中患者临床特点及中医学特征。方法:2011年5月—2012年3月住院治疗的急性缺血性脑卒中患者共161例,按照是否合并肺部感染分为研究组(感染组)及对照组(非感染组),其中研究组54例,对照组107例。比较两组患者危险因素、临床表现、中医证型和舌象,并通过相关性分析研究脑卒中并发肺部感染的相关因素。结果:1从临床特点角度:研究组高龄(≥80岁)、房颤、消化系统疾病史、语言障碍、吞咽困难、不自主运动、肢体瘫痪及排便障碍的比例较对照组显著高,与对照组比较,研究组入院时NIHSS显著高,BI及日常生活不依赖(MRS≤3)患者比例显著低;2从中医学特征角度:研究组阴虚风动型患者比例显著高于对照组,气虚血瘀型患者比例明显低于对照组,研究组无苔患者比例显著多于对照组;3多因素logistic回归分析发现,高龄(≥80岁)、房颤、消化系统病史、吞咽困难、NIHSS是并发肺部感染的独立危险因素(P<0.05),其OR值依次为3.221、4.984、4.105、3.34、2.296。结论:缺血性脑卒中并发肺部感染与高龄(≥80岁)、房颤史、消化系统疾病史、吞咽障碍、NIHSS显著相关;而脑梗死并发肺部感染患者中,阴虚风动型及无苔患者比例高,气虚血瘀型患者比例低。

Objective：To explore the clinical and TCM characteristics for patients with cerebral infarction comlicated with pulmonary infections. Methods：The participants included 161 patients with cerebral infarction in hospital from May,2011 to March,2012,according to the status of pulmonary infections,the participants were divided into the research group（infection group,54 patients）and the contral group（non-infection group,107 patients）. We compare risk factors,clinical symptoms,syndromes of TCM and tongue between the two groups,and find out the relative factors to cerebral infarction complicated pulmonary infections using logistic regression analysis. Results：（1）From clinical characteristics：the proportion of eld（≥ 80）,atrial fibrillation,history of digestive system diseases,language disorders,dysphagia,involuntary movement,paralysis of limbs and dysporia is significantly higher than that in control group;Compared with contral group,NIHSS was significantly higher,and BI and the proportion of patients with MRS ≤ 3 were significantly lower.（2）From TCM characteristics：Compared with control group,in research group the proportion of patients with Yin deficiency and wind act was higer,Qi deficiency and blood stasis was lower,and absence of tongue coating was more statistically. （3）Multivariate logistic anlysis revealed that eld（≥ 80）,atrial fibrillation,history of digestive system diseases,dysphagia and NIHSS were the independent risk factors for complicating with pulmonary infections,the OR values were 3.221,4.984,4.105,3.34,2.296 successively. Conclusion：Patients with cerebral infartion complicated with pulmonary infections was signicantly related with eld（≥ 80）,atrial fibrillation,history of digestive system diseases,dysphagia and NIHSS;and in those patients the proportion of Yin deficiency and wind act and absence of tongue coating was high,Qi deficiency and blood stasis was low.