降钙素原对接受静脉溶栓的急性脑梗死患者发生卒中相关性肺炎的预测价值

目的 探讨降钙素原(Procalcitonin,PCT)对接受静脉溶栓治疗的急性脑梗死患者发生卒中相关性肺炎(Stroke-associated pneumonia,SAP)的预测价值.方法 回顾性收集2016年1月-2019年12月在本院接受静脉溶栓的急性脑梗死患者的临床资料;采用单因素及多因素Logistic回归分...

Predictive value of procalcitonin for stroke-associated pneumonia in patients treated with intravenous thrombolysis

ObjectiveTo investigate the predictive value of procalcitonin(PCT)for stroke-associated pneumonia(SAP)in patients with acute ischemic stroke who received intravenous thrombolysis.Methods The clinical data of patients with acute ischemic stroke who received intravenous thrombolysis in our hospital from January 2016 to December 2019 were collected retrospectively. Univariate and multivariate logistic regression analysis was used to determine the independent risk factors of SAP in patients receiving intravenous thrombolysis. Spearman correlation analysis was used to assess the correlation between PCT and SAP. Receiver operating characteristic(ROC)curves were used to analyze the predictive values of PCT in the occurrence of SAP.Results A total of 157 patients with acute ischemic stroke who received intravenous thrombolysis were enrolled, of which 56 cases developed SAP(35.7%). There were significant differences in age, smoking, NIHSS score, dysphagia, symptomatic intracranial hemorrhage, leukocyte count, CRP level and PCT level between the SAP group and non-SAP group(P<0.05). The subjects were divided into groups according to the quartile of SAP. Spearman correlation analysis showed that PCT level was positively correlated with SAP occurrence(r=0.583,P<0.001). Multivariate logistic regression analysis showed that dysphagia(OR=4.211,95%CI=1.299～13.654), symptomatic intracranial hemorrhage(OR=9.245, 95%CI=1.161～73.635), CRP level(OR=1.041,95%CI=1.000～1.083), the third quantile of PCT level(OR=17.651, 95%CI=3.361～92.684)and the fourth quantile of PCT level(OR=65.287, 95%CI=11.504～370.509)were the independent predictors of SAP after intravenous thrombolysis. ROC curve analysis showed that the area under the curve of PCT for predicting SAP after intravenous thrombolysiswas 0.875(P<0.001). When the optimal cut-off value of PCT was 1.22 μg/mL, the sensitivity and specificity for predicting SAP were 85.7% and 83.2%, respectively, which is significantly better than the predictive value of CRP(Z=2.025,P<0.05).Conclusion For acute ischemic stroke patients, PCT was an independent predictor for SAP after intravenous thrombolysis.