《中国康复理论与实践》

《中国康复理论与实践》 ›› 2014, Vol. 20 ›› Issue (10): 967-970.

• 临床研究 • 上一篇    下一篇

卒中相关性肺炎危险因素分析

马跃文，郇赛，张带
   

  1. 中国医科大学附属第一医院康复医学科，辽宁沈阳市110001
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2014-10-25 发布日期:2014-10-25

Analysis of Risk Factors of Stroke-associated Pneumonia

MA Yue-wen, HUAN Sai, ZHANG Dai.
  

  1. The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2014-10-25 Online:2014-10-25

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摘要： 目的探讨卒中相关性肺炎(SAP)的相关危险因素。方法回顾性分析159 例脑卒中患者，根据有无发生SAP将其分为SAP组(n=35)和非SAP(n=124)组。对比两组患者的年龄、性别、高血压、糖尿病、胃黏膜保护剂、脑卒中后吞咽困难(DAS)、卒中史、卒中类型、低蛋白血症、意识障碍、鼻饲、吸烟等临床资料，用单因素分析和多因素Logistic 回归分析SAP的相关危险因素。结果159 例脑卒中患者SAP发生率为22.0%。单因素分析结果显示，年龄≥70 岁(P<0.01)、胃黏膜保护剂(P<0.01)、DAS(P<
0.01)、低蛋白血症(P<0.05)、意识障碍(P<0.05)、鼻饲(P<0.001)，吸烟(P<0.01)均与SAP发生有关。二分类Logistic 回归分析显示，年龄≥70 岁、DAS、鼻饲、吸烟是SAP发病的危险因素。控制其他因素，鼻饲饮食患者发生SAP风险最高，是非鼻饲患者的5.119倍。结论SAP的发病率高，是多因素共同作用的结果，鼻饲饮食患者发生SAP的可能性最高。

关键词: 脑卒中, 肺炎, 鼻饲, 吞咽障碍, 危险因素

Abstract: Objective To explore the risk factors of stroke- associated pneumonia (SAP) in stroke patients. Methods A retrospective study was designed to analyze the clinical data of 159 patients with stroke. They were divided into SAP group (n=35) and non-SAP group (n=124). Their age, gender, hypertension, diabetes mellitus, gastric mucosal protective agents, dysphagia after stroke (DAS), stroke history, type of stroke, hypoproteinemia, disturbance of consciousness, nasal feeding and smoking were analyzed with univariate analysis and multivariate Logistic regression analysis. Results 22% of the 159 patients suffered from SAP. Univariate analysis showed, there was statistical difference in age (P<0.01), gastric mucosal protective agents (P<0.01), DAS (P<0.01), hypoalbuminemia (P<0.05), disturbance of consciousness (P<0.05), nasal feeding (P<0.001) and smoking (P<0.01) between two groups. Binary Logistic regression for the multivariate analysis indicated that age≥70 years old, DAS, nasal feeding and smoking were the risk factors related with SAP. After adjusting for all other variables, the odds of SAP were 5.119 times higher for patients requiring nasal feeding than those without nasal feeding. Conclusion There is a high morbidity for SAP, which is attributed to multiple factors. Age≥70, DAS, nasal feeding and smoking may be the most important risk factors related with SAP.

Key words: stroke, pneumonia, nasal feeding, dysphagia, risk factors