摘要
目的 探讨卒中相关性肺炎（SAP）的危险因素及病原学特点.方法 收集167例SAP患者（SAP组）及179例无SAP急性脑卒中患者（对照组）的临床资料,分析SAP的危险因素.对SAP组患者进行痰培养.结果 SAP组＞65岁、男性、慢性阻塞性肺疾病（COPD）、心脏病史、高血压病史、吞咽困难、格拉斯哥昏迷量表（GCS）评分≤8分、美国国立卫生研究院卒中量表评分＞10分、气管切开、使用呼吸机、留置胃管、使用抑酸剂的比率及住院天数均显著高于对照组（P ＜0.05 ～0.01）.Logistic回归分析显示,＞65岁、COPD、吞咽困难、GCS评分≤8分、心脏病史及使用抑酸剂是SAP的独立危险因素.SAP组死亡率显著高于对照组（P＜0.05）.痰标本培养出病原体16种,其中G-杆菌占55.25％,G＋球菌占17.13％,真菌占26.52％.结论 ＞ 65岁、COPD、吞咽困难、GCS评分≤8分、心脏病史及使用抑酸剂是SAP的独立危险因素.SAP患者致病菌以G-杆菌为主.
Objective To investigate the risk factors of stroke-associated pneumonia （SAP） and its pathogenic characteristics.Methods Clinical data of 167 SAP patients （SAP group） and 179 acute stroke patients without SAP （control group） were collected,and the risk factors of SAP were analyzed.The sputum culture were conducted in SAP group.Results In SAP group,The rates of age 〉 65 years,male,chronic obstructive pulmonary disease （COPD）,heart disease,hypertension,dysphagia,Glasgow coma score ≤ 8,National Institutes of Health Stroke Scale 〉 10,tracheotomy,using ventilation,indwelling gastric tube,using acid-suppressive drugs and hospitalization days were significantly higher than those in control group （P 〈 0.05-0.01）.Logistic regression showed age 〉 65 years,chronic obstructive pulmonary disease,dysphagia,Glasgow coma score ≤ 8,heart disease and using acidsuppressive drugs were the independent risk factors of SAP.The mortality of the SAP group was significantly higher than control group （P 〈 0.05）.There were 16 kinds of pathogens were cultivated,including Gram negative bacilli （55.25%）,gram positive cocci （17.13%） and fungus （26.52%）.Conclusion Age 〉 65 years,COPD,dysphagia,decreased consciousness,heart disease,using acid-suppressive drugs are independent risk factors of SAP.The mainly pathogen is gram-negative bacilli.
出处
《临床神经病学杂志》
CAS
北大核心
2014年第1期53-55,共3页
Journal of Clinical Neurology
关键词
急性脑卒中
卒中相关肺炎
危险因素
病原学
acute cerebral stroke
stroke-associated pneumonia
risk factors
etiology
