王姝梅 1李海英 1袁俊亮 1秦伟 1李淑娟 1胡文立1
作者信息
摘要
Abstract
Objective To investigate the relationship between stroke - associated pneumonia ( SAP ) and the severity and prognosis of ischemic stroke. Methods 94 patients with ischemic stroke admitted to Beijing Chaoyang Hospital of Capital Medical University from February 2012 to June 2012 were divided into SAP group ( 49 cases ) and non - SAP group ( 45 cases ). General clinical data ( age, gender, histories of hypertension, diabetes, hyperlipidemia, coronary heart disease, atrial fibrillation, remote cerebral infarction, malignant tumor and smoking ), clinical manifestations ( severity of focal nerve defect, disturbance of consciousness and dysphagia ), neuroimaging results ( stroke area and location ), disease assessment and prognosis assessment ( hospitality, NIHSS score on admission, NIHSS after confirming SAP, APACHE Ⅱ score and Rankin score on discharge ), laboratory test results and etiological examination results. The related factors of SAP and the relationship between SAP and stroke severity ( NIHSS score ), health condition ( APACHE Ⅱ ), prognosis ( improved Rankin score ) and hospitality, as well as the laboratory testing results and etiology distribution were all analyzed. Results Occurrence of age >75 years, disturbance of consciousness, dysphagia, cerebral infarction in multiple parts, NIHSS > 15 and APACHE Ⅱ > 20 between SAP group and control group showed statistically significant differences ( P < 0. 05 ). The NIHSS score and Apache Ⅱ score on admission, Rankin score on discharge, hospitality and mortality between SAP group and non - SAP group showed statistically significant differences ( P < 0. 05 ). The NIHSS on admission and NIHSS on discharge in SAP group also showed statistically significant difference ( P <0. 05 ). The levels of C reactive protein, brain natriuretic peptide, prealbumin, albumin and erythrocyte sedimentation rate between SAP group and non - SAP group showed statistically significant differences ( P < 0. 05 ). Etiology examination showed that 39 cases were positive and 10 cases were negative with a positive rate of 80% . The results showed 31 strains of gram negative bacilli ( 9 strains of Acinetobacter baumanii ), 9 strains of gram positive coccus ( 8 strains of staphylococcus au-reus ) and 23 strains of fungi ( 9 strains of Candida albicans ). Conclusion Conclusion SAP can aggravate the symptoms of ischemic stroke, extend hospitality, increase mortality and lead to poor prognosis. The understanding of SAP should be enhanced and appropriate prevention should be given to the patients.关键词
卒中/呼吸道感染/卒中相关性肺炎/疾病严重程度/预后Key words
Stroke/ Respiratory tract infection/ Stroke - associated pneumonia/ Severity of illness/ Prognosis分类
医药卫生
