摘要
目的 探讨急性脑梗死机械取栓术后并发呼吸机相关性肺炎(VAP)的危险因素及A2DS2评分量表的预测价值。方法 回顾性收集2020年1月—2021年12月在中国科学技术大学附属第一医院神经内科因急性脑梗死行机械取栓住院的273例患者的临床病例资料,根据是否合并VAP分为VAP组(180例)和非VAP组(93例)。对所有患者进行A2DS2评分,采用多因素logistic回归分析探究不同因素与肺炎的关系,采用受试者工作特征曲线(ROC)评价A2DS2量表对VAP的预测价值。结果 年龄、住院时间、高血压病史、随机血糖、美国国立卫生研究院卒中量表(NIHSS)评分、中性粒细胞与淋巴细胞比值(NLR)、A2DS2评分与VAP发生相关(均P<0.05);住院时间长及既往高血压病史是VAP发生的独立危险因素(OR=1.112,95%CI:1.053~1.173,P<0.001;OR=1.970,95%CI:1.130~3.433,P=0.017);A2DS2≥5分是VAP发生的独立危险因素(OR=2.412,95%CI:1.382~4.210,P=0.002);A2DS2评分量表对VAP有预测价值(AUC为0.651,95%CI:0.580~0.721,灵敏度为0.733,特异度为0.484,最佳截断值为5分)。结论 年龄、住院时间、高血压病史、随机血糖、NIHSS评分、NLR、A2DS2评分与VAP发生相关;住院时间长、既往高血压病史、高A2DS2评分是VAP的独立危险因素;A2DS2评分量表对卒中合并VAP有预测价值。
Objective To investigate the risk factors of ventilator-associated pneumonia(VAP)after mechanical thrombectomy in acute stroke and the predictive value of A2DS2 score scale.Methods From January 2020 to December 2021,the clinical data of 273 patients admitted to the Department of Neurology,the First Affiliated Hospital,University of Science and Technology of China(USTC)for acute cerebral infarction were retrospectively collected.The patients were divided into VAP group(180 cases)and non-VAP group(93 cases).A2DS2 scores were obtained for all patients.Multivariate logistic regression analysis was used to investigate the relationship between various factors and pneumonia.Receiver operating characteristic curve(ROC)was used to evaluate the predictive value of the A2DS2 scale for VAP.Results Age,length of hospital stay,history of hypertension,random blood glucose,NIHSS score,neutrophil to lymphocyte ratio(NLR),A2DS2 score were correlated with VAP(all P<0.05).length of hospital stay and history of hypertension were independent risk factors for VAP(OR=1.112,95%CI:1.053-1.173,P<0.001;OR=1.970,95%CI:1.130-3.433,P=0.017);A2DS2≥5 points was an independent risk factor for VAP(OR=2.412,95%CI:1.382-4.210,P=0.002).The A2DS2 score scale had predictive value for VAP(AUC=0.651,95%CI:0.580-0.721,sensitivity was 0.733,specificity was 0.484,and optimal cut-off value was 5 points).Conclusion Age,hospitalization days,history of hypertension,random blood glucose,NIHSS score,NLR,A2DS2 score were correlated with VAP.Long hospital stay,history of hypertension and high A2DS2 score were independent risk factors for VAP.The A2DS2 score scale has predictive value for stroke combined with VAP.
作者
范亭亭
李瑞
朱余友
孙文
胡伟
王国平
FAN Tingting;LI Rui;ZHU Yuyou;SUN Wen;HU Wei;WANG Guoping(Department of Neurology,the First Affiliated Hospital of University of Science and Technology of China,Hefei,Anhui 230001,China)
出处
《中华全科医学》
2023年第10期1654-1656,1788,共4页
Chinese Journal of General Practice
基金
国家自然科学基金青年基金项目(82001452)。
