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首次发生急性缺血性卒中患者急性卒中阶段的肺炎与3年死亡率之间的关联

Association between pneumonia in acute stroke stage and 3-year mortality in patients with acute first-ever ischemic stroke.

作者信息

Yu Yi-Jing, Weng Wei-Chieh, Su Feng-Chieh, Peng Tsung-I, Chien Yu-Yi, Wu Chia-Lun, Lee Kuang-Yung, Wei Yi-Chia, Lin Shun-Wen, Zhu Jun-Xiao, Huang Wen-Yi

机构信息

Department of Neurology, Chang-Gung Memorial Hospital, Keelung Branch, No. 222, Mai-Jin Road, Keelung, Zip. 204, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, Zip. 333, Taiwan.

Department of Neurology, Chang-Gung Memorial Hospital, Keelung Branch, No. 222, Mai-Jin Road, Keelung, Zip. 204, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, Zip. 333, Taiwan.

出版信息

J Clin Neurosci. 2016 Nov;33:124-128. doi: 10.1016/j.jocn.2016.02.039. Epub 2016 Jul 16.

Abstract

The influence of pneumonia in acute stroke stage on the clinical presentation and long-term outcomes of patients with acute ischemic stroke is still controversial. We investigate the influence of pneumonia in acute stroke stage on the 3-year outcomes of patients with acute first-ever ischemic stroke. Nine-hundred and thirty-four patients with acute first-ever ischemic stroke were enrolled and had been followed for 3years. Patients were divided into two groups according to whether pneumonia occurred during acute stroke stage or not. Clinical presentations, risk factors for stroke, laboratory data, co-morbidities, and outcomes were recorded. The result showed that a total of 100 patients (10.7%) had pneumonia in acute stroke stage. The prevalence of older age, atrial fibrillation was significantly higher in patients with pneumonia in acute stroke stage. Total anterior circulation syndrome and posterior circulation syndrome occurred more frequently among patients with pneumonia in acute stroke stage (P<0.001 and P=0.009, respectively). Multivariate Cox regression revealed that pneumonia in acute stroke stage is a significant predictor of 3-year mortality (hazard ratio=6.39, 95% confidence interval=4.03-10.11, P<0.001). In conclusion, pneumonia during the acute stroke stage is associated with increased risk of 3-year mortality. Interventions to prevent pneumonia in acute stroke stage might improve ischemic stroke outcome.

摘要

急性卒中阶段的肺炎对急性缺血性卒中患者临床表现及长期预后的影响仍存在争议。我们研究急性卒中阶段的肺炎对首次发生急性缺血性卒中患者3年预后的影响。纳入934例首次发生急性缺血性卒中的患者,并对其进行3年随访。根据急性卒中阶段是否发生肺炎将患者分为两组。记录临床表现、卒中危险因素、实验室数据、合并症及预后情况。结果显示,共有100例患者(10.7%)在急性卒中阶段发生肺炎。急性卒中阶段发生肺炎的患者中,老年、心房颤动的患病率显著更高。急性卒中阶段发生肺炎的患者中,完全前循环综合征和后循环综合征的发生率更高(分别为P<0.001和P=0.009)。多因素Cox回归显示,急性卒中阶段的肺炎是3年死亡率的显著预测因素(风险比=6.39,95%置信区间=4.03-10.11,P<0.001)。综上所述,急性卒中阶段的肺炎与3年死亡风险增加相关。预防急性卒中阶段肺炎的干预措施可能改善缺血性卒中的预后。

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