Department of Rehabilitation Medicine, Saitama Medical University International Medical Center, Saitama, Japan.
J Stroke Cerebrovasc Dis. 2013 Aug;22(6):857-61. doi: 10.1016/j.jstrokecerebrovasdis.2012.06.008. Epub 2012 Aug 9.
This retrospective study examined the effectiveness of cilostazol in preventing aspiration pneumonia in patients with acute cerebral infarction. The 189 subjects ranged in age from 31 to 95 years and included 57 with small-artery occlusion, 107 with large-artery atherothrombosis, and 25 with other disorders. Patients with cardiogenic cerebral embolism or preexisting pneumonia at the time of hospital admission were excluded from the analysis. Neurologic symptoms, cognitive function, and swallowing function were assessed at the first clinical examination, and the ability to perform activities of daily living was assessed at both hospital admission and discharge. Outcome and food intake status were also assessed at hospital discharge. Pneumonia was detected in 27 of 189 subjects (14.3%), in 20 subjects during nasogastric tube feeding implemented because of oral intake difficulties (fasting group) and in 7 subjects after initiation of oral feeding (oral intake group). Cilostazol was administered to 48 of the 189 subjects (25.4%). The incidence of pneumonia was 6.3% (3 of 48) in patients who received cilostazol, compared with 17% (24 of 141) in those who did not receive cilostazol. Our data suggest that cilostazol appears to prevent the occurrence of pneumonia in both the chronic and acute stages of cerebral infarction.
本回顾性研究旨在探讨西洛他唑预防急性脑梗死患者吸入性肺炎的效果。189 例患者年龄 31~95 岁，其中小动脉闭塞 57 例，大动脉粥样硬化血栓形成 107 例，其他病变 25 例。患有心源性脑栓塞或入院时已有肺炎的患者被排除在分析之外。在首次临床检查时评估神经症状、认知功能和吞咽功能，并在入院和出院时评估日常生活活动能力。出院时还评估了预后和食物摄入情况。189 例患者中，27 例（14.3%）发生肺炎，20 例（禁食组）因口腔摄入困难而进行鼻饲时发生肺炎，7 例（经口进食组）开始经口进食后发生肺炎。189 例患者中，48 例（25.4%）接受了西洛他唑治疗。接受西洛他唑治疗的患者肺炎发生率为 6.3%（3/48），未接受西洛他唑治疗的患者肺炎发生率为 17%（24/141）。我们的数据表明，西洛他唑似乎可预防脑梗死慢性期和急性期肺炎的发生。
