脑梗死患者肺部感染的相关危险因素分析

目的 探讨脑梗死患者发生肺部感染的相关危险因素.方法 共纳入520例脑梗死患者,按照是否合并有肺部感染分为感染组及非感染组,其中感染组140例,非感染组380例；应用非条件logistic回归分析进行多因素分析.结果 单因素分析显示,两组患者有慢性阻塞性肺疾病(COPD)病史、意识障碍、吞咽困难、卧床、高血压病史、糖尿病史、吸烟史、大面积脑梗死、冠心病史及年龄≥65岁的感染率比较,差异有统计学意义(P＜0.05)；多因素非条件logistic回归分析结果表明,COPD病史、意识障碍、吞咽困难、高血压病史、糖尿病史、大面积脑梗死、冠心病史是脑梗死患者发生肺部感染的独立危险因素(P＜0.05),其中COPD及意识障碍的影响最大,其OR值为16.25、8.36.结论 COPD病史、意识障碍、吞咽困难、高血压病史、糖尿病史、大面积脑梗死、冠心病史是脑梗死患者发生肺部感染的独立危险因素,而合并COPD及意识障碍的患者更容易发生肺部感染；对该类人群的危险因素进行必要的干预,可降低肺部感染的发生率,改善患者的预后.

Risk factors for pulmonary infections in cerebral infarction patients

OBJECTIVE To explore the related risk factors for pulmonary infections in the cerebral infarction patients.METHODS The participants included 520 patients with cerebral infarction,according to the status of pulmonary infections,the participants were divided into the infection group(140 patients) and the non-infection group(380 cases);the multivariate factors were analyzed by using non-conditional logistic regression analysis.RESULTS The univariate analysis showed that the difference in the infection rate of the patients with COPD,disorder of consciousness,dysphagia,the stay in bed,hypertension,diabetes,smoking,large area cerebral infarction,coronary heart disease and age more than 65 years was statistically significant(P<0.05);the multivariate non-conditional logistic regression analysis revealed that COPD,disorder of consciousness,dysphagia,hypertension,diabetes,large area cerebral infarction,and coronary heart disease were the independent risk factors for the pulmonary infections in the cerebral infarction patients(P<0.05),COPD and disorder of consciousness were the most significantly influencing factors,the OR values were 16.25 and 8.36 respectively.CONCLUSION The COPD,disorder of consciousness,dysphagia,hypertension,diabetes,large area cerebral infarction,and coronary heart disease are the independent risk factors for the pulmonary infections in the cerebral infarction patients,yet the patients complicated with COPD or disorder of consciousness are more prone to the pulmonary infections;it is of great significance to implement the inventions in the risk factors for this group of patients,which can reduce the incidence of pulmonary infections and improve the patient′s prognosis.