脑血管病与感染(附118例报告)

目的　探讨感染在脑血管病发生发展中所起的作用。方法　收集１１８ 例脑血管病（ 年龄＞ ４５ 岁） 尸检病例的临床与病理资料，对脑梗死与脑出血起病前后的感染进行比较分析。结果　①脑梗死组有感染的患者（４８／６１ ，７８７ ％ ） 比脑出血组（２４／５７ ，４２１ ％ ） 显著增多（ Ｐ＜ ０ ．０１） ，两组都以起病后合并感染者居多，但脑梗死组起病前１ 周有感染者占２５ ％ ，比脑出血的１２５ ％ 多１ 倍。②感染以细菌性感染为主，肺炎居首位（７３６ ％ ） ，菌血症与腹泻次之，各占８３ ％ 与６９ ％ 。③脑梗死组有感染的比无感染的患者，血白细胞计数值明显增多（ Ｐ＜ ００１） 。④脑梗死及脑出血的部位与感染的发生无相关性（ Ｐ＞ ００５） 。结论　脑梗死患者感染的发生率高于脑出血患者。脑梗死患者起病前的近期感染可能成为发病的危险因素之一，而脑血管病患者起病后合并感染是其致残、致死的重要原因之一。

The relationship of cerebrovascular disease and infection

Objective The aim of the study was to investigate the role played by infection in the onset and course of cerebrovasular disease (CVD). Methods The data about pathologic examination and clinical materials were investigated in 118 consecutive patients with cerebral stroke so as to analyzed the relationship between infection and cerebrovascular disease. The case control study between cerebral hemorrhage(CH) and cerebral infarction (CI) was compared.Results (1) Infections were more common in CI than CH patients ( P<0.01 ). Infections were more frequent after ictus of stroke in CI and CH patients, but the recent infections before onset of stroke in 25% of CI patients were two times as high as in 12.5% of CH patients. (2) The infections were mostly of bacterial origin. Pulmonary infections were the most common in 73.5% of those patients, secondly, septicemia and diarrhea in 8.3% and 6.9% respectively. (3) Leukocyte counts were markedly higher in the CI patients with than those without infections. (4) There was no relationship between the regions of CI or CH and infections. Conclusions It was suggested that there are closer relation between CI and infections. The recent infections before onset of stroke infections may be a risk factor for CI, while the infections after onset of the stroke may be one of causes of increased disablement and mortality.