缺血性脑卒中患者并发肺部感染的病原菌特征及血清炎性因子水平变化分析

Characteristics of Pathogenic Bacteria and Changes of Serum Inflammatory Factors in Pulmonary Infection in Patients with Ischemic Stroke

目的:探讨缺血性脑卒中(CIS)并发肺部感染(PI)患者的病原菌分布特征,以及血清炎性因子水平的变化情况。方法:选取2022年1月—2023年6月通辽市医院神经内科收治的CIS合并PI患者69例为观察组,另选同期入院的CIS患者71例作为对照组。采用全自动微生物鉴定仪鉴定痰液中的病原菌,采用酶联免疫吸附法检测血清中炎性因子,采用多因素Logistic回归分析CIS合并PI的影响因素。结果:69例观察组患者共检出病原菌85株,其中革兰阴性菌51株,占比最高(60.00%)。观察组患者血清炎性因子C反应蛋白(CRP)、白细胞介素6(IL-6)及降钙素原(PCT)水平均高于对照组,差异有统计学意义(P<0.0001)。Logistic回归分析结果显示,CRP、IL-6及PCT均为CIS合并PI的危险因素(P<0.05)。结论:CIS患者并发PI时,其病原菌主要为革兰阴性菌,且合并PI患者血清中炎性因子水平明显升高,CRP、IL-6及PCT水平是CIS并发PI的危险因素。

Objective:To investigate the distribution of pathogenic bacteria and the changes of serum inflammatory factors in patients with ischemic stroke(CIS)complicated with pulmonary infection(PI).Methods:Sixty-nine CIS patients with PI admitted to the Department of Neurology of Tongliao Hospital from January 2022 to June 2023 were selected as the observation group,and seventy-one CIS patients admitted during the same period were selected as the control group.The pathogenic bacteria in sputum were identified by automatic microbial identification instrument,and the inflammatory factors in serum were detected by enzymelinked immunosorbent assay.Multivariate Logistic regression was used to analyze the influencing factors of CIS combined with PI.Results:A total of 85 strains of pathogenic bacteria were detected in 69 observation group,of which 51 were gram-negative,accounting for the highest proportion(60.00%).Serum levels of inflammatory factor C-reactive protein(CRP),interleukin 6(IL-6)and procalcitonin(PCT)in observation group were higher than those in control group,with statistical significance(P<0.0001).Logistic regression analysis showed that CRP,IL-6 and PCT were risk factors for CIS and PI(P<0.05).Conclusion:When CIS patients complicated with PI,the pathogens were mainly gram-negative bacteria,and the serum levels of inflammatory factors in patients with PI were significantly increased,and the levels of CRP,IL-6 and PCT were risk factors for CIS complicated with PI.