嗜酸性粒细胞计数与急性缺血性卒中患者卒中相关性肺炎的相关性

Correlation between eosinophil count and stroke associated-pneumonia in patients with acute ischemic stroke

目的探讨嗜酸性粒细胞计数与急性缺血性卒中患者卒中相关性肺炎(stroke-associated pneumonia,SAP)的相关性。方法前瞻性纳入2016年8月至2018年9月在苏州市中西医结合医院脑病科住院的发病24 h内的急性缺血性卒中患者。收集患者一般临床资料及嗜酸性粒细胞计数,采用美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评估卒中严重程度。应用多变量logistic回归分析确定SAP的独立危险因素。结果共纳入521例患者,其中106例(20.35%)发生SAP。单变量logistic分析显示,SAP与嗜酸性粒细胞计数分类有关[优势比(odds ratio,OR)0.37,95%可信区间(confidence interval,CI)0.20~0.68;P=0.001],倾向于与嗜酸性粒细胞计数有关(OR 0.08,95%CI 0.01~1.01;P=0.051)。多变量logistic回归分析显示,嗜酸性粒细胞计数及嗜酸性粒细胞计数分类均非SAP的独立危险因素,而高龄(OR 1.077,95%CI 1.045~1.109;P<0.001)、慢性阻塞性肺疾病(OR 6.931,95%CI 1.295~37.106;P=0.024)和高基线NIHSS评分(OR 1.148,95%CI 1.003~1.314;P=0.045)则与SAP显著独立相关。结论嗜酸性粒细胞计数并非急性缺血性卒中患者发生SAP的独立预测因素。

Objective To Investigate the correlation of eosinophil count and stroke-associated pneumonia(SAP)in patients with acute ischemic stroke.Methods Patients with acute ischemic stroke within 24 h after onset admitted to the Department of Encephalopathy,Suzhou Integrated Traditional Chinese and Western Medicine Hospital from August 2016 to September 2018 were enrolled prospectively.Their general clinical data and eosinophil counts were collected.National Institutes of Health Stroke Scale(NIHSS)was used to assess the severity of stroke.Multivariate logistic regression analysis was used to determine the independent risk factors for SAP.Results A total of 521 patients were enrolled,including 106(20.35%)SAP.Univariate logistic analysis showed that SAP was associated with the classification of eosinophil count(odds ratio[OR]0.37,95%confidence interval[CI]0.20-0.68;P=0.001),and tended to be associated with eosinophil count(OR 0.08,95%CI 0.01-1.01;P=0.051).Multivariate logistic regression analysis showed that both eosinophil count and eosinophil count classification were not the independent risk factors for SAP,and advanced age(OR 1.077,95%CI 1.045-1.109;P<0.001),chronic obstructive pulmonary disease(OR 6.931,95%CI 1.295-37.106;P=0.024)and high baseline NIHSS score(OR 1.148,95%CI 1.003-1.314;P=0.045)were significantly independently associated with SAP.Conclusions Eosinophil count was not an independent predictor of SAP in patients with acute ischemic stroke.