摘要目的 探讨急性卒中后肺炎的独立危险因素.方法 对2009年7月1日-2011年6月30日在上海交通大学附属第一人民医院和同济大学附属东方医院住院治疗的545例急性卒中患者进行肺炎发生的相关危险因素分析.先做单因素分析,筛选出影响急性卒中后肺炎发生的相关危险因素.根据单因素分析结果及相关专业知识,拟合多因素非条件Logistic回归模型,调整相关的混杂因子,找出影响急性卒中后肺炎发生的独立危险因素.结果 急性卒中后肺炎的发生率为11.0％(60/545).年龄≥80岁(OR=6.024,95％CI:1.923～18.868,P=0.002)、出血性卒中(OR=3.546,95％CI:1.266～9.901,P=0.016)、卧床(OR=4.295,95％ CI:1.642～11.233,P=0.003)、基线Glasgow昏迷量表≤8分(OR=5.127,95％CI:1.377～19.090,P=0.015)、基线Barthel指数＜50分(OR=8.403,95％CI:1.468～47.619,P=0.017)、营养不良(OR=10.625,95％CI:3.260～ 34.631,P =0.000)和基线空腹血糖≥7.0 mmol/L( OR=10.000,95％CI:3.115～32.258,P=0.000)为急性卒中后肺炎的独立危险因素,而早期康复治疗是急性卒中后肺炎的保护因素(OR =0.159,95％ CI:0.055 ～0.466,P=0.001).结论 急性卒中后肺炎发生率高,危险因素多,采取综合性干预措施有助于早期识别及防治急性卒中后肺炎.

abstractsObjective To explore the independent risk factors related to acute post-stroke pneumonia.Methods A total of 545 inpatients with acute stroke in Shanghai First People's Hospital Affiliated to Shanghai Jiaotong University and East Hospital Affiliated to Tongji University during July 1,2009 to June 30,2011 were enrolled.Single-factor analysis was performed to identify the risk factors of acute post-stroke pneumonia. According to the results of single-factor analysis and relevant professional knowledge,fitting multi-factor non-conditional Logistic regression model,adjusting the relevant confounded factors,the independent risk factors were analyzed.Results The incidence of acute post-stroke pneumonia was 11.0％ (60/545).The independent risk factors of acute post-stroke pneumonia were:age ≥ 80 year ( OR =6.024,95％ CI:1.923 - 18.868,P =0.002 ),hemorrhagic stroke ( OR =3.546,95％ CI:1.266 -9.901,P =0.016),stay in bed ( OR =4.295,95％ CI:1.642 - 11.233,P =0.003 ),baseline Glasgow coma scale ≤8 ( OR =5.127,95％ CI:1.377 - 19.090,P =0.015 ),baseline Barthel index ＜50 ( OR =8.403,95％ CI:1.468 -47.619,P =0.017 ),malnutrition ( OR =10.625,95％ CI:3.260 -34.631,P =0.000 ),baseline fasting plasma glucose ≥ 7.0 mmol/L ( OR =10.000,95％ CI:3.115 -32.258,P =0.000); and early rehabilitation was the protective factor (OR =0.159,95％ CI:0.055 -0.466,P =0.001 ).Conclusions The incidence of acute post-stroke pneumonia is high,and it is relatedwith many independent risk factors.Comprehensive interventions may contribute to early identify and prevent acute post-stroke pneumonia.