腔隙性脑梗死合并卒中相关性肺炎病原学及危险因素分析研究

目的:探讨腔隙性脑梗死(LI)合并卒中相关性肺炎(SAP)患者的病原学特点及危险因素。方法:回顾性分析2016年收治90例LI合并SAP患者(感染组)的临床资料,并通过医院病案抽样系统随机选取同期94例LI未合并SAP患者(对照组)的临床资料。结果:感染组痰标本检测出病原体27种,G~+菌、G~-菌、真菌分别占22.22%、62.96%、14.82%;检测出病原体113株,G~+菌、G~-菌、真菌分别占9.73%、65.49%、24.78%。与对照组相比,感染组血D-二聚体、超敏C反应蛋白(hs-CRP)、甘油三酯、高密度脂蛋白、载脂蛋白A、白蛋白、合并高血压和血脂代谢异常存在显著性差异(P0.05或P0.01)。多因素回归分析表明,2组间血清hs-CRPOR=1.210,95%CI(1.059,1.383)]、合并高血压OR=34.863,95%CI(2.151,565.057)]具有统计学差异(P0.05或P0.01)。结论:LI合并SAP患者致病菌主要为G-菌。血hs-CRP、合并高血压为LI合并SAP的独立危险因素。

The analysis for etiology and risk factors of lacunar infarction patients with stroke-associated pneumonia

Objective: To study the pathogenic characteristics and risk factors in lacunar infarction (LI) patients with stroke-associated pneumonia (SAP). Methods: There were 184 LI patients admitted in 2016, including 90 cases with SAP (infected group) and 94 cases without SAP (control group) in the same period which randomly selected. The clinical data were retrospectively analyzed. Results: 27 kinds pathogens were detected, including gram negative bacilli (22.22%), gram positive cocci (62.96%) and fungus (14.28%). And 113 cases pathogens were detected, ncluding gram negative bacilli (9.73%), gram positive cocci (65.49%) and fungus (24.78%). The univariate analysis showed that, compared with control group, several factors were statistically different (p < 0.05), including D-Dimer, hyper-sensitive C-reactive protein (hs-CRP), triglycerides, high-density lipoprotein, apolipoprotein A, albumin, associated with hypertension and dyslipidemia. The result of multivariate logistic regression analysis indicated that hs-CRP OR = 1.210, 95% CI (1.059, 1.383)] and associated with hypertension OR = 34.863, 95% CI (2.151, 565.057)] were statistically different (p < 0.05). Conclusion: Pathogens in patients with LI and SAP were mainly gram negative bacteria. Hs-CRP and associated with hypertension are independent factors in LI patients with SAP.