脑与神经疾病杂志
腦與神經疾病雜誌
뇌여신경질병잡지
JOURNAL OF BRAIN AND NERVOUS DISEASES
2015年
3期
211-214
,共4页
卒中%卒中相关性感染%单核粒细胞%预测价值%危险因素
卒中%卒中相關性感染%單覈粒細胞%預測價值%危險因素
졸중%졸중상관성감염%단핵립세포%예측개치%위험인소
Stroke%Stroke-associated infection%Mononuclear cells%Predictive value%Risk factors
目的:探讨卒中相关性肺炎(SAI)患者的危险因素及外周血单核粒细胞计数对其预测价值。方法入选的病后24 h内入院的急性重症脑卒中患者为研究对象,收集所有研究对象临床资料,分析其相关危险因素,检测1d、2d、7d和14d的单核粒细胞计数,采用接收者工作特征曲线( ROC)判断单核粒细胞计数对SAI的预测价值。结果①78例研究对象中有31例发生SAI,发病率为39.74%。SAI危险因素中发生肺部感染的相对危险度分析显示,肺部疾病,呛咳症状,美国国立卫生研究院卒中量表( NIHSS)评分≥12分,急性生理与慢性健康评估Ⅱ( APACHEⅡ)≥20分,年龄≥65岁,吸烟,昏迷患者发生SAI危险性相对高。78例重症卒中患者中有19例死亡,死亡率为24.35%,其中SAI患者死亡16例,死亡率为84.21%,显著高于非SAI患者死亡率(15.79%),差异有统计学意义(P<0.05);②SAI组与非SAI组单核粒细胞计数比较,差异有统计学意义(均P<0.05);③生存组和死亡组单核粒细胞计数比较,差异有统计学意义(均P<0.01);④对单核粒细胞计数进行ROC曲线分析,入院第2天的单核粒细胞计数对SAI的发生有预测价值。结论急性重症脑卒中患者SAI的发生率和病死率均较高,其危险因素主要为年龄≥65岁,肺部疾病,吸烟,呛咳症状,GCS≤7分, NIHSS≥12分,APACHEⅡ≥20分。其发病后单核粒细胞计数升高明显增加感染易感性,单核粒细胞计数≥0.46×109/L对SAI的发生有一定的预价值。
目的:探討卒中相關性肺炎(SAI)患者的危險因素及外週血單覈粒細胞計數對其預測價值。方法入選的病後24 h內入院的急性重癥腦卒中患者為研究對象,收集所有研究對象臨床資料,分析其相關危險因素,檢測1d、2d、7d和14d的單覈粒細胞計數,採用接收者工作特徵麯線( ROC)判斷單覈粒細胞計數對SAI的預測價值。結果①78例研究對象中有31例髮生SAI,髮病率為39.74%。SAI危險因素中髮生肺部感染的相對危險度分析顯示,肺部疾病,嗆咳癥狀,美國國立衛生研究院卒中量錶( NIHSS)評分≥12分,急性生理與慢性健康評估Ⅱ( APACHEⅡ)≥20分,年齡≥65歲,吸煙,昏迷患者髮生SAI危險性相對高。78例重癥卒中患者中有19例死亡,死亡率為24.35%,其中SAI患者死亡16例,死亡率為84.21%,顯著高于非SAI患者死亡率(15.79%),差異有統計學意義(P<0.05);②SAI組與非SAI組單覈粒細胞計數比較,差異有統計學意義(均P<0.05);③生存組和死亡組單覈粒細胞計數比較,差異有統計學意義(均P<0.01);④對單覈粒細胞計數進行ROC麯線分析,入院第2天的單覈粒細胞計數對SAI的髮生有預測價值。結論急性重癥腦卒中患者SAI的髮生率和病死率均較高,其危險因素主要為年齡≥65歲,肺部疾病,吸煙,嗆咳癥狀,GCS≤7分, NIHSS≥12分,APACHEⅡ≥20分。其髮病後單覈粒細胞計數升高明顯增加感染易感性,單覈粒細胞計數≥0.46×109/L對SAI的髮生有一定的預價值。
목적:탐토졸중상관성폐염(SAI)환자적위험인소급외주혈단핵립세포계수대기예측개치。방법입선적병후24 h내입원적급성중증뇌졸중환자위연구대상,수집소유연구대상림상자료,분석기상관위험인소,검측1d、2d、7d화14d적단핵립세포계수,채용접수자공작특정곡선( ROC)판단단핵립세포계수대SAI적예측개치。결과①78례연구대상중유31례발생SAI,발병솔위39.74%。SAI위험인소중발생폐부감염적상대위험도분석현시,폐부질병,창해증상,미국국립위생연구원졸중량표( NIHSS)평분≥12분,급성생리여만성건강평고Ⅱ( APACHEⅡ)≥20분,년령≥65세,흡연,혼미환자발생SAI위험성상대고。78례중증졸중환자중유19례사망,사망솔위24.35%,기중SAI환자사망16례,사망솔위84.21%,현저고우비SAI환자사망솔(15.79%),차이유통계학의의(P<0.05);②SAI조여비SAI조단핵립세포계수비교,차이유통계학의의(균P<0.05);③생존조화사망조단핵립세포계수비교,차이유통계학의의(균P<0.01);④대단핵립세포계수진행ROC곡선분석,입원제2천적단핵립세포계수대SAI적발생유예측개치。결론급성중증뇌졸중환자SAI적발생솔화병사솔균교고,기위험인소주요위년령≥65세,폐부질병,흡연,창해증상,GCS≤7분, NIHSS≥12분,APACHEⅡ≥20분。기발병후단핵립세포계수승고명현증가감염역감성,단핵립세포계수≥0.46×109/L대SAI적발생유일정적예개치。
Objective To explore the risk factors of stroke-associated infection , ( SAI ) and its predictive value from peripheral blood mononuclear cell count .Methods We selected patients with acute severe stroke within 24h after admission, and collected clinical data .We analyzed the related risk factors , and detected 1 d, 2 d, 7 d and 14 d of mononuclear cell count , using the receiver operating characteristic curve ( ROC) judged mononuclear cell countvaluefortheforecastofSAI.Results ①Therewere31casesofSAIinthe78cases,incidenceof39.74%. There were more risk factors of SAI , such as lung disease , choking cough symptoms , the United States National Institutes of Health Stroke Scale ( NIHSS) score 12 points or greater , acute physiology and chronic health evaluationⅡ(APACHEⅡ) 20 points or more, age 65 or higher, smoking, coma SAI.19 cases severe stroke patients were died , the mortality was 24.35%, the death of 16 patients with SAI, mortality was 84.21%, there were significantly higher than that in patients with non SAI mortality rate (15.79%) (P<0.05); ②In the two groups, there were statistically significant for mononuclear cell counts ( all P<0.05);③In the survival group and death group there were statistically significant for mononuclear cell counts ( all P<0.01);④the ROC curve analysis was carried out on the mononuclear cell count, On the 2nd day, the mononuclear cell counts had the predictive value for SAI .Conclusion The patients with acute severe cerebral apoplexy SAI both incidence and case fatality rate is higher .After the onset of mononuclear cell count has certain dynamic change law of mononuclear cell count in SAI has a certain value .