急性脑卒中患者并发感染对预后的影响

目的:探讨急性脑卒中并发感染对患者预后的影响。方法:对449例急性脑卒中患者给予相应药物治疗,记录入院时体温及住院期间最高体温;评估出院时巴氏指数(BI)、改良的Rankin量表评分(mRS)和减少的美国国立卫生研究所脑卒中评分(NIHSS)百分数,出院后6个月随访,记录病死率及BI、mRS。结果:住院期间感染者(感染组)290例,无感染者(无感染组)159例。感染组住院期间最高体温明显高于无感染组(P<0.01),年龄明显大于无感染组(P<0.01),住院时间明显长于无感染组(P<0.05);出院时及随访时BI均低于无感染组(P<0.01,P<0.05);出院时减少的NIHSS百分数明显低于无感染组(P<0.01),mRS明显高于无感染组(P<0.01);随访时病死率明显高于无感染组(P<0.01)。结论:卒中后并发感染不仅影响急性脑卒中患者的神经功能恢复,而且影响卒中后病死率。急性脑卒中并发感染患者的预后较未并发感染者差。

Effect of Complicated Infection on Outcome of Patients with Acute Cerebral Strokes

Objective:The effect of complicated infections on prognosis of patients with acute cerebral strokes has been observed.Methods: Four hundred and forty-nine acute cerebral stroke patients confirmed by cranial CT scan or MR were prospectively divided into non-infection(290 cases) and infection(159 cases) groups.The body temperature of all the patients was recorded on admission and during hospitalization.NIHSS,BI,and mRS were documented in all the cases,and the mortality rate was recorded.The difference in prognosis between the two group patients was analyzed.Results:The maximum body temperature of infection group was higher than that of the noninfection during hospitalization(P<0.01).The functional outcome of the patients complicated with infections was significantly worse than that of the cases without infections,assessed by BI(P<0.01),mRS(P<0.01)and NIHSS(P<0.01) on being discharged from the hospital and by BI(P<0.05) 6 months later.The mortality in the patients complicated with infections was significantly higher than that in the cases without infections(P<0.01).Conclusion:Infections that occur in the patients with acute cerebral strokes not only have influence on functional outcome but also on mortality.The prognosis of acute cerebral stroke patients complicated with infection is not good.