上海交通大学学报（医学版）

›› 2009, Vol. 29 ›› Issue (10): 1230-.

• 论著（临床研究） • 上一篇    下一篇

急性脑卒中后发生肺炎的危险因素分析

冯智英, 李 颖, 李焰生   

  1. 上海交通大学 医学院仁济医院神经内科, 上海 200127
  • 出版日期:2009-10-25 发布日期:2009-10-26
  • 作者简介:冯智英（1970—）, 女, 副主任医师, 硕士生；电子信箱: chengwei690311@hotmail.com。

Risk factors for pneumonia in patients with acute stroke

FENG Zhi-ying, LI Ying, LI Yan-sheng   

  1. Department of Neurology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
  • Online:2009-10-25 Published:2009-10-26

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摘要：

目的 分析急性脑卒中后并发肺炎的危险因素。方法 分析340例急性脑卒中患者的临床资料，评估脑卒中后发生肺炎的危险因素，包括人口学因素、高血压病史、糖尿病史、吸烟史、入院时的体温和血压、空腹血糖、C-反应蛋白、神经功能缺损程度评分（NIHSS）、吞咽功能和辅助机械通气（MV）等情况，分析肺炎评分与肺炎的关系。结果 340例患者中并发肺炎63例（18.5%）。多变量Logistic回归分析提示年龄、性别、入院时NIHSS、MV和吞咽困难是急性脑卒中后发生肺炎的独立危险因素(P＜0.05)。肺炎的发生率随肺炎评分的增加而逐渐增高。结论 脑卒中后肺炎的发生与老年、男性、吞咽困难、MV和NIHSS有关，肺炎评分可以用来评估脑卒中后肺炎发生的风险性。

关键词: 急性脑卒中, 肺炎, 危险因素, 神经功能缺损程度评分, 肺炎评分

Abstract:

Objective To assess the risk factors for pneumonia in patients with acute stroke. Methods Three hundred and forty patients with acute stroke were studied, and risk factors for pneumonia such as demographics, history of hypertension, diabetes and smoking, initial blood pressure, body temperature, fasting plasma glucose level, C-reactive protein, National Institutes of Health Stroke Scale (NIHSS) scores, degree of dysphagia and mechanical ventilation were evaluated. Besides, the correlation between incidence of pneumonia and pneumonia scores in patients with acute stroke was studied. Results Pneumonia was developed in 63 patients (18.5%). Logistic regression analysis revealed that age, gender, initial NIHSS scores, dysphagia and mechanical ventilation were independent predictors for pneumonia (P<0.05). The incidence of pneumonia gradually increased with the pneumonia scores. Conclusion The occurrence of pneumonia after acute stroke is associated with older age, male gender, high NIHSS scores, dysphagia and mechanical ventilation. The pneumonia scores can be adopted to identify the risks of pneumonia after acute stroke.

Key words: acute stroke, pneumonia, risk factor, NIHSS, pneumonia score

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