使用血管紧张素转换酶抑制剂对降低老年脑卒中肺炎的评价

目的：评价血管紧张素转换酶抑制剂（ACEI）对老年脑卒中患者医院内肺炎的作用。方法：对75例年龄≥65岁老年脑卒中住院患者使用ACEI观察4周，并与同期300例未使用ACEI组老年脑卒中住院患者作对照，分别对肺炎发生率及其影响因素作分析。结果：医院内肺炎发生率分别为17.3%、31．6％，（P＜0．01）。调整已知肺炎危险因素：糖尿病、低蛋白血症、缺血性心脏病、慢性肺病、肾功能不全、制酸剂、糖皮质激素，相对危险度为0．55，P＝0．014。两组肺炎死亡率无差异。结论：ACEI是降低脑卒中患者医院内肺炎危险的一个独立因素，对老年脑卒中患者肺炎有预防作用。

Evaluation of Reducing Incidence of Pneumonia Associated with Use of AngiotensionI Converting Enzyme Inhibitors in Elderly Stroke Inpatients

Objective: To evaluate the effect of angiotensin I converting enzyme(ACE) inhibitors on incidence of pneumonia in elderly cer stroke patients. Methods:75 stroke patients over 65 years useing ACE inhibitors for four weeks were observed and compared with 300 elderly stroke patients not using ACE inhibitors. Incidence of pneumonia and affected factors were analyzed respectively. Results:Incidence of pneumonia was 17.3% in the stroke patients and 31.6% in the controls(p<0.01). After adjustment for known risk factors(ie.diabetes mellitus, hypoalbuminemia, ischemic heart disease, chronic lung disease, renal insufficiency, antacids, steroids) ,the relative risk estimates for pneumonia were 0. 55 (95% confidence interval 0.32-0.92 ) and P = 0.014. There was no significant difference between mortality of patients and the controls. Conclusion: ACE inhibitor is an independent factor reducing risk of pneumonia and has ability to prevent the pneumonia in elderly cerebral stroke patients.