摘要
目的观察急性重症脑卒中患者外周血单核细胞计数的变化规律,探讨其对脑卒中相关性感染(SAI)的预测价值。方法前瞻性研究连续入选的病后24h内入院的急性重症脑卒中患者,以同期住神经内科病房中的头晕患者(排除急性脑卒中)作为对照组。检测第1、2、4、6和14天的单核细胞计数,采用接收者工作特征曲线(ROC)判断单核细胞计数对SAI的预测价值。结果脑卒中组与对照组单核细胞计数比较差异均有统计学意义(P<0.05),脑梗死组与脑出血组比较差异均无统计学意义(P>0.05),感染组与非感染组比较差异均有统计学意义(P<0.05),生存组与死亡组比较差异均有统计学意义(P<0.01)。以第2天单核细胞计数>0.41×109/L对SAI的发生有预测价值。结论急性重症脑卒中患者病后单核细胞计数动态变化。单核细胞计数升高增加感染的易感性,对SAI的发生有一定的预测价值,持续升高的患者预后不佳。
Objective To explore the changes of monocyte counts in peripheral blood and its predictive value to stroke-associated infection （SAD in critically ill patients with acute stroke. Methods In our prospective study, all the patients were enrolled consecutively and admitted to hospital within 24h after stroke symptoms onset. The dizzy patients （acute stroke was excluded） admitted to our hospital were served as control group in the same period. Blood samples were collected serially on 1st, 2nd, 4th, 6th and 14th day, the monocyte counts were determined by blood autoanalyser. Results The monocyte counts in stroke group compared with control group had significant differences in the same time point （all P〈0.05）. Ischemic stroke group compared with hemorrhagic stroke group, there were no significant differences （all P〉0.05）. Infection group compared with non-infection group, there were significant differences （all P〈0.05）. Survival group compared with death group, there was significant difference in the same time point （all P〈0.01）. On 2nd day, the monocyte counts more than 0.41×10^9/L had the predictive value to SAI. Conclusion The monocyte counts sustain a dynamic change in critically ill patients with stroke. The increase of monocyte counts contributes to the infection with critically acute stroke patients, and probably predicts the occurrence of SAL The progressive increase of monocyte counts appears a bad prognosis.
出处
《中国实用神经疾病杂志》
2009年第11期14-16,共3页
Chinese Journal of Practical Nervous Diseases
