实用临床医药杂志2025，Vol.29Issue(16)：1-8,13,9.DOI:10.7619/jcmp.20251876
意识水平和中性粒细胞与淋巴细胞比值对不同程度神经功能缺损患者发生卒中相关性肺炎的中介效应分析
Mediating effect of disturbance of consciousness and neutrophil-to-lymphocyte ratio on stroke-associated pneumonia in patients with different degrees of neurological dysfunction
摘要
Abstract
Objective To explore the mediating effects of potential mediating factors on occur-rence of stroke-associated pneumonia(SAP)in patients with varying degrees of neurological deficit based on real-world case data.Methods A total of 902 hospitalized patients in the acute phase of stroke were selected as study subjects.Clinical characteristics were compared among patients with dif-ferent degrees of neurological deficit and those with SAP.R studio was employed to generate a correla-tion heatmap of potential mediating factors,enabling the identification of primary potential mediating factors.Multivariate logistic regression analysis was conducted to assess the impact of the degree of neurological deficit,potential mediating factors,and stroke-associated pneumonia.R studio was also used to analyze the interaction between the degree of neurological deficit and potential mediating factors,as well as the mediating role of potential mediating factors in the association between neurological deficit and SAP.Results Based on the results of the correlation heatmap,this study screened out five major potential mediating factors,namely consciousness level,neutrophil-to-lymphocyte ratio(NLR),chlorine(Cl),fasting blood glucose(FBG)and albumin(ALB).Multivariate logistic re-gression analysis revealed that the degree of neurological deficit was significantly associated with the level of consciousness,NLR,Cl,FBG levels and the occurrence of SAP.Interaction analysis dem-onstrated an interaction between the degree of neurological deficit and FBG levels.Mediation analy-sis indicated that the total effect of the association between neurological deficit and SAP was 0.302.Both the level of consciousness and NLR exhibited partial mediating effects in the association be-tween neurological deficit and SAP,with mediating effect proportions of 25.92％and 15.15％,re-spectively.Conclusion Consciousness level and NLR have partial mediating effects in the occur-rence of SAP in patients with different neurological deficits.There is an interaction between the de-gree of neurological deficit and the level of FBG.关键词
卒中/卒中相关性肺炎/空腹血糖/中性粒细胞-淋巴细胞比值/中介分析/影响因素/炎症标志物/神经功能缺损程度Key words
stroke/stroke-associated pneumonia/fasting blood glucose/neutrophil-to-lym-phocyte ratio/mediation analysis/influencing factors/inflammatory markers/degree of neurological deficit分类
医药卫生引用本文复制引用
金佳欣,马鹏珍,陈婷婷,谢颖桢..意识水平和中性粒细胞与淋巴细胞比值对不同程度神经功能缺损患者发生卒中相关性肺炎的中介效应分析[J].实用临床医药杂志,2025,29(16):1-8,13,9.基金项目
国家重点研发计划课题(2017YFC1700101) （2017YFC1700101）
北京市科技计划课题(Z191100006619065) （Z191100006619065）
中央高水平中医医院临床科研业务费资助项目(DZMG-MLZY-23003) （DZMG-MLZY-23003）
