急性脑梗死患者卒中相关性肺炎危险因素分析

摘要

目的：分析急性脑梗死患者卒中相关性肺炎的危险因素。方法回顾性收集1084例急性脑梗死患者的临床资料，分析脑梗死急性期卒中相关性肺炎（ASP）的风险。结果在1084例患者中并发肺炎270例（24．9％），经过单因素分析，将差异有统计学意义的变量纳入多变量 Logistic 回归分析，结果显示：年龄≥70岁、慢性支气管炎、低白蛋白血症、大面积脑梗死、鼻饲、意识障碍、呛咳、空腹高血糖、应激性溃疡、出血转化等是脑梗死患者急性期 SAP 危险因素。结论年龄≥70岁、慢性支气管炎、低白蛋白血症、大面积脑梗死、鼻饲、意识障碍、呛咳、空腹高血糖、应激性溃疡、出血转化是脑梗死后 SAP 发生的重要预测因素。因此通过临床指标的观测，及早识别及针对性地采取预防措施，可以降低 SAP 的发生率、减少住院时间、降低病死率、改善卒中预后。%Objective To investigate the risk factors for stroke‐associated pneumonia (SAP ) in patients with acute cerebral infraction .Methods The clinical data of 1 084 acute cerebral infraction patients were retrospec‐tively analyzed and the risk factors for stroke‐associated pneumonia after cerebral infraction were assessed.Results Of 1 084 cases ,270 cases (24 .9% ) occurred SAP .Using univariate analysis ,a total of 17 factors with statisti‐cal significance were included ,and then multivariate logistic regressive analysis revealed that age ≥ 70 years ,chron‐ic bronchitis ,lower level of serum albumin ,massive cerebral infarction ,nasogastric tube feeding ,unconscious‐ness ,dysphagia ,stress ulcer and hemorrhagic transformation were determined as the independent risk factors for SAP( P < 0 .05) .Conclusion Age ≥ 70 years ,chronic bronchitis ,lower level of serum albumin ,massive cerebral infarction ,nasogastric tube feeding ,unconsciousness ,dysphagia ,stress ulcer and hemorrhagic transformation were observed as important predictors of SAP after acute cerebral infarction .Therefore ,through the observation of clinical indicators ,the risk of SAP can be distinguished ,and targeted measures can be used to reduce the incidence of SAP ,the hospitalization days ,the mortality rate and improve the prognosis.