| 段 霞,侯景明,洪 健,闵令霞,龚秋文,周小萍,刘宏亮.脑卒中后吞咽障碍患者发生相关性肺炎的危险因素及预测模型分析[J].中国康复医学杂志,2022,(5):616~622 |
| 脑卒中后吞咽障碍患者发生相关性肺炎的危险因素及预测模型分析 点此下载全文 |
| 段 霞 侯景明 洪 健 闵令霞 龚秋文 周小萍 刘宏亮 |
| 陆军军医大学第一附属医院康复科，重庆市，400038 |
| 基金项目：国家自然科学基金项目（U19A2082）；重庆市自然科学基金项目（2020jstg048） |
| DOI：10.3969/j.issn.1001-1242.2022.05.008 |
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| 摘要： |
| 摘要
目的：分析脑卒中后吞咽障碍患者住院期间发生卒中相关性肺炎(SAP)的危险因素和预测模型。
方法：回顾性分析我院2017年1月至2021年12月收治的脑卒中的吞咽障碍患者149例，根据是否存在SAP分为SAP组和非SAP组，统计分析患者年龄、性别、高血压史、临床并发症、疾病损伤特点、入院血液学指标、康复评定数据等指标，多因素Logistic回归分析发生SAP的独立危险因素，并采用ROC曲线分析相关因素对SAP的预测价值。
结果：多因素Logistic回归分析提示，高血压病史、吸烟史、留置胃管、洼田饮水试验简况Ⅴ、中性粒细胞/淋巴细胞比值（NLR）高是SAP的独立危险因素，改良Barthel指数≥40分是SAP的保护因素；ROC曲线分析提示，NLR联合洼田饮水试验预测SAP能力的曲线下面积为0.767（P＜0.001，95% CI 0.691—0.843），临界值、灵敏度、特异度分别为0.612、0.701、0.774。
结论：高血压病史、吸烟史、留置胃管、洼田饮水试验简况Ⅴ、高NLR值是脑卒中吞咽障碍患者发生SAP的独立危险因素，改良Barthel指数≥40分是SAP的保护因素，且NLR联合洼田饮水试验对是否发生SAP有较好的预测作用。 |
| 关键词：脑卒中 吞咽障碍 卒中相关性肺炎 危险因素 预测模型 |
| Risk factors and predictive model of stroke-associated pneumonia in patients with dysphagia Download Fulltext |
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| Department of Rehabilitation Southwest Hospital， Third Military Medical University， Chongqing， 400038 |
| Fund Project: |
| Abstract: |
| Abstract
Objective： To analyze the risk factors and prediction models of stroke-associated pneumonia (SAP) in patients with dysphagia during hospitalization.
Method： One hundred and forty-nine stroke patients with dysphagia admitted to our hospital from January 2017 to December 2021 were retrospectively analyzed. According to the presence of SAP， they were divided into SAP group and non-SAP group. Statistical analysis was conducted on the age， gender， history of hypertension， clinical comorbidity， disease injury characteristics， admission hematology indicators， rehabilitation assessment data and other indicators. Multivariate Logistic regression was used to analyze the independent risk factors for SAP， and ROC curve was used to analyze the predictive factors for SAP.
Result： Multivariate Logistic regression analysis showed that hypertension， smoking， indentation gastric tube， profile V of kubota water swallowing test and high NLR were independent risk factors for SAP， and modified Barthel index ≥40 points was a protective factor for SAP. ROC curve analysis showed that the area under the curve of NLR combined with kubota water swallowing test was 0.767 (P＜0.001， 95%CI 0.691—0.843)， and the cutoff， sensitivity and specificity were 0.612， 0.701 and 0.774.
Conclusion： Hypertension， smoke， indentation gastric tube， profile V of kubota water swallowing test and high NLR were independent risk factors for SAP in patients with dysphagia after stroke. Modified Barthel index ≥40 points was a protective factor for SAP， and NLR combined with water swallowing test had a good predictive effect on SAP in patients with dysphagia after stroke. |
| Keywords:stroke dysphagia stroke-associated pneumonia risk factors prediction model |
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