急性缺血性脑卒中患者口腔清洁度异常与卒中相关性肺炎的影响因素及关系

Mutually actingrisk roles of oral cleanliness and stroke-associated pneumonia in patients with acute ischemic stroke:A case-control study

目的分析急性缺血性脑卒中患者口腔卫生与卒中相关性肺炎(SAP)的影响因素及关系。方法纳入331例急性缺血性脑卒中患者,收集患者基本资料、神经功能缺损评分和口腔卫生习惯等信息。根据口腔卫生状态及是否发生SAP分组比较,以二元logistic回归分析口腔清洁度异常和SAP的危险因素。结果回归分析显示,SAP(OR=2.219,P=0.026)、龋齿(OR=1.292,P=0.005)和年龄(OR=1.030,P=0.006)是脑卒中患者口腔清洁度的独立危险因素,而Barthel指数评分(OR=0.986,P=0.019)是其保护因素;BOAS评分(OR=1.972,P<0.001)与NIHSS评分(OR=1.322,P<0.001)是SAP的独立危险因素。结论急性缺血性脑卒中患者口腔清洁度异常与SAP互为独立危险因素,保护口腔卫生也许有助于SAP预防。

Objective To analyze the influencing factors and correlation of oral hygiene and stroke-associated pneumonia(SAP)in patients with acute ischemic stroke.Methods We performed a cross-sectional study by recruiting 331 patients with acute ischemic strokefrom two medical centers.A series of assessments were performed to evaluate the neurological status and habits of oral hygiene.Univariate analyses were performed firstly on the conditions of oral hygiene and occurrence of SAP.Multiple logistic regression analyses were conducted to find risk factors of oral cleanness and SAP in the stroke patients.Results After adjusting the confounders,multivariable logistic regression analysis showed that SAP(OR=2.219,P=0.026),dental caries(OR=1.292,P=0.005)and age(OR=1.030,P=0.006)were the risk factors for oral cleanness in those stroke patients,while the score of Barthel index(OR=0.986,P=0.019)was a protective factor.BOAS score(OR=1.972,P<0.001)and NIHSS score(OR=1.322,P<0.001)were the risk factors for SAP.Conclusion The abnormality of oral cleanness and SAP are the and mutually acting risk factors in patients with acute ischemic stroke.Protecting oral hygiene may be helpful for SAP prevention.