ISAN评分对缺血性脑卒中后肺炎预测作用的临床研究

目的 探讨ISAN评分对缺血性脑卒中后并发肺炎的预测作用.方法 采用回顾性研究方法,选择2012年1月至2016年8月重庆市梁平人民医院神经科收治的缺血性脑卒中后并发肺炎患者189例,缺血性脑卒中后未并发肺炎患者509例.比较两组患者临床特征(年龄、性别、卒中程度、卒中前神经功能、既往病史、吸烟史),运用Logistic回归模型分析缺血性脑卒中患者并发肺炎的相关危险因素,运用ROC曲线分析方法评价ISAN评分对缺血性脑卒中后肺炎的预测作用.结果 单因素分析结果显示,两组年龄、男性、卒中程度(NIHSS评分)、卒中前神经功能(mRS评分)、房颤和卒中病史差异有统计学意义(P<0.05).多因素Logistic回归分析显示,高龄、男性、卒中程度和卒中前神经功能为缺血性脑卒中后肺炎的独立危险因素.ROC曲线分析结果显示,ISAN评分预测缺血性脑卒中后肺炎的曲线下面积为0.7895%CI:(0.70,0.88)],差异有统计学意义(P<0.001).结论 ISAN评分能有效预测缺血性脑卒中后肺炎发生的风险.

The Clinical Study on the Predicative Effect of the ISAN Score on the Pneumonia After Ischemic Stroke

Objective To evaluate the predictive effect of the ISAN score on the pneumonia in patients with ischemic stroke.Methods The Retrospective study was conducted in the 189 patients with pneumonia after ischemic stroke and the 509 patients without pneumonia after ischemic stroke from January of 2012 to August of 2016 in Liangping County People's Hospital of Chongqing.The comparison were made between the two groups in the clinical characteristics including age, sex, stroke severity, pre-stroke neurological function, previous medical history, and smoking history.The logistic regression was used to analyze the risk factors associated with pneumonia in patients with ischemic stroke.The ROC curve analysis was adopted to evaluate the predictive value of the ISAN score for post-ischemic stroke pneumonia.Results The results of the univariate analysis showed significant differences between the two groups in age, male, stroke severity (NIHSS score), pre-stroke neurological function (mRS score), atrial fibrillation and stroke history (P<0.05).The results of the multivariate logistic regression analysis showed that the independent risk factors for post-ischemic stroke pneumonia involved age, male, stroke severity, and pre-stroke neurological function.The results of the ROC curve analysis showed that the area under curve (AUC) of the ISAN score was 0.78 (95%CI: 0.70-0.88), which was statistically significant (P<0.001).Conclusion The ISAN score can effectively predict the risk of developing pneumonia after ischemic stroke.