论著

遵义地区4 604例住院新生儿TORCH感染状况分析

Analysis of TORCH infection status of 4 604 hospitalized neonates in Zunyi area

:5-8
 
目的 了解遵义地区住院新生儿TORCH感染状况、发病率,为相关疾病的早期预防和治疗提供重要参考依据。方法 采用回顾性研究方法,对遵义市妇幼保健院2018—2019年住院新生儿弓形虫(TOX)、风疹(RV)、巨细胞(CMV)和单纯疱疹病毒(HSV)Ⅰ型感染结果进行分析。结果 遵义地区4 604例住院新生儿TORCH-IgM的总体阳性率为1.35%,其中CMV、TOX、RV、HSV Ⅰ的阳性率分别是1.00%、0.20%、0.13%和0.02%;对应TORCH-IgG的阳性率分别是67.38%、0.91%,54.54%、22.22%。对2018—2019年住院新生儿TORCH感染筛查结果显示:CMV-IgM阳性率分别从1.47%下降到0.43%(χ2=4.981,P=0.026),RV-IgM的阳性率从0.24%下降到0.00(χ2=12.446,P<0.001),差异均有统计学意义。在研究的2 607例男性患儿中,CMV、TOX、RV、HSV Ⅰ的IgM阳性率率分别是0.19%、0.11%、0.96%和0.04%,其IgG的阳性率为1.07%、55.20%、67.93%和22.48%。在研究的1 997例女性患儿中,CMV、TOX、RV、HSV Ⅰ的IgM阳性率分别是0.20%、0.15%、1.05%和0.00%,其IgG的阳性率为0.70%、53.68%、66.65%和21.88%。不同CMV-IgM感染对谷丙转氨酶(ALT)和谷草转氨酶(AST)的活性影响研究中,CMV-IgM抗体阳性对照组的ALT活性高于阴性组(t=-2.793,P<0.05),AST的活性无差异(t=0.067,P>0.05) 结论 遵义地区4 604例住院新生儿中以CMV感染率相对较高,不容忽视。2018—2019年CMV和RV的新近感染率呈下降趋势。CMV-IgM的感染能引起ALT活性的升高。
Objective To reveal the TORCH infection status and incidence of hospitalized newborns in Zunyi area, and provide important reference for early prevention and treatment of related diseases. Methods The retrospective research method was used to analyze the infection results of toxoplasma gondii (TOX), rubella virus (RV), cytomegalovirus (CMV) and herpes simplx virus (HSV) type I in hospitalized newborns in Zunyi Maternal and Child Health Hospital from 2018 to 2019. Results The overall positive rate of TORCH-IgM in 4 604 hospitalized newborns in Zunyi area was 1.35%, of which the positive rates of CMV, TOX, RV, and HSV Ⅰ were 1.00%, 0.20%, 0.13% and 0.02%, respectively; the corresponding TORCH-IgG positive rates were 67.38%, 0.91%, 54.54%, 22.22%. The TORCH infection screening results of neonates hospitalized in 2018—2019 showed that the CMV-IgM positive rate decreased from 1.47% to 0.43% (χ2=4.981, P=0.026), and the RV-IgM positive rate decreased from 0.24% to 0.00 (χ2=12.446, P< 0.001), the differences were statistically significant. In 2 607 male children, the IgM positive rates of CMV, TOX, RV and HSVⅠwere 0.19%, 0.11%, 0.96% and 0.04%, respectively; and the corresponding IgG positive rates were 1.07%, 55.20%, 67.93% and 22.48%. In 1 997 female children, the IgM positive rates of CMV, TOX, RV and HSVⅠwere 0.20%, 0.15%, 1.05% and 0.00,respectively; and the corresponding IgG positive rate was 0.70%, 53.68%, 66.65% and 21.88%. In the study of effects of different CMV-IgM infection on alanine aminotransferase(ALT) and aspartate aminotransferase(AST) activity, the ALT activity of CMV-IgM positive group was significantly higher than that of negative group (t=-2.793, P<0.05), and there was no difference in AST activity between the two groups (t=0.067, P>0.05). Conclusions The CMV infection rate among 4 604 hospitalized newborns in Zunyi area was relatively high, which should not be ignored. The recent infection rates of CMV and RV showed a downward trend from 2018 to 2019. CMV-IgM infection could cause an increase in ALT activity.
专题论著: 新型冠状病毒肺炎

深圳市某健康驿站14例新冠病毒肺炎病例的感染来源分析

Analysis and discussion on the source of infection of 14 COVID-19 cases in a health station in Shenzhen

:17-21
 
目的 分析探讨健康驿站新冠病毒肺炎病例感染来源,评估驿站站内感染风险,规范驿站管理,降低感染风险。方法 对驿站2022年2月21日—3月9日全部14例新冠肺炎病例自入境到报告进行全链条风险分析。结果 14例病例为7批次不同时间入住,其中病例1、2、3、4、5、6、7、8、9、10、12、13共12例病例入境后即确诊,病例11入住5天(其共同入境、同住人员病例10,入境后即确诊)确诊、病例14入住10天发病确诊,其余病例均未呈现感染发病时间特异性,未呈现入境后交叉感染时间特异性,未见入住后空间、通风系统、排污系统交集,未见交叉感染情况。结论 该驿站目前报告新冠肺炎病例均有相关旅居史,主要在香港本土感染。13名病例大概率均在香港感染,入境隔离时发病确诊,其中病例1、2、3、4,病例6、7、8,病例10、11是3起呈现家庭聚集性感染发病,病例5、9是独立个案,病例14需要进一步排除,驿站未规范管理会导致误报及进一步扩大站内感染风险。
Objective To investigate and analyze the source of infection of COVID-19 cases in health station, assess the risk of infection, standardize the management and reduce the risk of infection. Methods From February 21 to March 9, 2022, the whole chain risk analysis of all 14 COVID-19 cases from entry to reporting was carried out. Results Fourteen cases were admitted in 7 batches at different times. Except for case 11 who diagnosed at the 5th day (the case of co-entry and co-resident case 10 was diagnosed after entry), and case 14 who diagnosed at the 10th day, the rest of the cases were diagnosed after entry, which did not show infection-onset time specificity, no time specificity of cross-infection after entry, no intersection of space, ventilation system and sewage system after entry, and no cross-infection. Conclusions The COVID-19 cases reported by the station were mainly infected in Hong Kong. Those 13 cases were highly likely infected in Hong Kong, all were diagnosed at the time of entry quarantine, while cases 1~4, cases 6~8, and cases 10~11 were 3 cases of family cluster infection, case 5 and 9 were an independent case, and case 14 needed to be further investigation. Failure to standardize the management of the station will lead to false alarms and further increase the risk of infection in the station.
论著

IPF、H-IPF在血流感染中的应用价值

Application value of IPF and H-IPF in bloodstream infection

:36-41
 
目的 研究未成熟血小板分数(IPF)、高荧光未成熟血小板比例(H-IPF)指标在血流感染中的早期诊断价值。方法 选取2020年7月—2021年1月广州市第一人民医院的血培养阳性患者100例作为主要的研究对象,重症病人对照50例,健康对照50例。收集各组患者IPF、H-IPF、大型血小板比率(P-LCR)、血小板体积分布宽度(PDW)、粒/淋、粒/单指标的数值,采用单因素方差分析、构建ROC曲线的方法分析比较各组的IPF、H-IPF、P-LCR、PDW、粒/淋、粒/单比值的差异及其与血流感染效能的关系。结果 IPF、H-IPF、粒/淋、粒/单比值在血流感染组高于其他2组,差异有统计学意义(χ2分别是15.190,10.250,39.490,12.850;P<0.05),而 P-LCR、PDW在3组之间无统计学意义。其中,IPF与H-IPF对血流感染诊断效能较高,其中IPF的AUC为0.855(95% CI为0.737~0.973),H-IPF的AUC为0.845(95% CI为0.722~0.968)。结论 IPF、H-IPF与血流感染密切相关,这2个指标对血流感染患者具有一定的诊断价值。
Objective To explore the early diagnosis value of immature platelet fraction (IPF) and high fluorescent immature platelet fraction (H-IPF) in bloodstream infection.Methods A total of 100 patients with positive blood culture result from July 2020 to January 2021 in Guangzhou First People's Hospital were selected as the research objects,in the mean while,50 critically ill patients and 50 healthy patients were enrolled as two control groups.The values of IPF,H-IPF,platelet-large cell rate (P-LCR),platelet distribution width (PDW),neutrophils/lymphocytes,neutrophils/monocyte ratio of patients in each group were collected,and one-way analysis of variance and ROC curve were used to compare the data,to further analyze their relationship with the bloodstream infection.Results The IPF,H-IPF,neutrophils/lymphocytes,neutrophils/monocyte ratio in the bloodstream infection group were significantly higher than control groups,with statistical significance (χ2=15.190,10.250,39.490,12.850; P<0.05),while P-LCR and PDW had no statistical significance.Among them,IPF and H-IPF were highly effective in diagnosing bloodstream infection,the AUC of IPF was 0.855 (95% CI: 0.737-0.973) and the AUC of H-IPF was 0.845 (95% CI: 0.722-0.968).Conclusions IPF and H-IPF were closely related to bloodstream infection,and these two indicators had a certain value in diagnosing patients with bloodstream infection.
论著

支气管镜下肺泡灌洗阿米卡星治疗老年支气管扩张合并感染患者的疗效

Effect of bronchoscopic alveolar lavage with amikacin in elderly patients with bronchiectasis complicated with infection

:31-35
 
目的 探究支气管镜下肺泡灌洗并局部使用阿米卡星治疗老年支气管扩张合并感染患者的疗效及对血清炎性因子水平的影响。方法 选取我院2018年3月—2019年5月确诊支气管扩张症、合并感染的符合纳入标准的患者共64例,按照1:1比例抽签分为2组,32例纳入观察组,应用支气管镜下肺泡灌洗阿米卡星治疗;32例纳入对照组,以单纯的支气管镜下肺泡灌洗治疗。观察并比较2组患者的治疗效果、血清炎性因子水平、肺功能情况等。结果 疗效比较显示观察组的96.9%总有效率高于对照组的75.0%(P<0.05);血清炎性因子水平在患者用药前检测无差异(P>0.05),经过治疗后,观察组水平均优于对照组P<0.05;经治疗后,观察组静态肺活量、补呼气量、补吸气量、用力肺活量均优于对照组,差异具有统计学意义(P<0.05)。结论 对老年支气管扩张合并感染患者应用支气管镜下肺泡灌洗阿米卡星治疗,促进临床效果改善,患者的症状、炎症及肺功能等指标均得到明显改善,值得推广。
Objective To investigate the efficacy of bronchoscopic alveolar lavage and local application of amikacin in the treatment of elderly patients with bronchiectasis complicated with infection and its effect on the level of serum inflammatory factors.Methods A total of 64 patients with bronchiectasis complicated with infection diagnosed in our hospital from March 2018 to May 2019 were selected.They were divided into two groups evenly by proportional drawing. Thirty-two cases were included in the observation group that were treated with bronchoscopic alveolar lavage with amikacin.The other 32 cases were included in the control group that were treated with the bronchoscopic alveolar lavage only.The therapeutic effect,serum inflammatory factor level and pulmonary function of the two groups were observed and compared.Results The total effective rate of 96.9% in observation group was higher than 75.0% in control group (P<0.05).There was no difference in the levels of serum inflammatory factors before treatment (P>0.05).After treatment,the levels of the observation group were better than those of the control group (P<0.05).After treatment,the slow vital capacity,expiratory reserve volume,inspiratory reserve volume and forced vital capacity of the patients in the observation group were better than those in the control group (P<0.05).Conclusions Bronchoscopic alveolar lavage of amikacin in elderly patients with bronchiectasis complicated with infection could improve the clinical effect.The symptoms of the patients,the serum inflammatory factors and lung function of the patients were significantly improved.The treatment is worthy of promotion.
论著

广东粤西北农村妇女高危型HPV感染情况分析

Analysis of high-risk HPV infection among rural women in northwestern Guangdong

:22-26
 
目的 了解广东肇庆怀集县农村妇女两年来“两癌”检测的阳性情况及高危型人乳头瘤病毒(HPV)的感染特点。 方法 对2018年1月—2019年12月24 146名参与“两癌”免费检测的35~64 岁、农村妇女的宫颈癌筛查结果进行分析。以高危型HPV检测作为初筛方法,结果为HPV16、18型阳性的转诊阴道镜检查,其它高危型HPV阳性则进行薄层宫颈液基细胞学检查(TCT),TCT结果严重于或等于未明确意义的非典型鳞状上皮(ASC-US)者转诊阴道镜,阴道镜结果可疑或异常者进行组织病理学检查。 结果 高危型HPV总检出率为9.35%,单独HPV16、18和其它高危型HPV的阳性检出率分别为0.70%、0.32%、7.72%,混合感染检出率为0.61%,高危型 HPV 总检出率最高的年龄段是 60~64岁,检出率为11.22%。细胞学转诊率为65.63%,阴道镜转诊率为61.23%。宫颈癌前病变检出率为323.03/10 万,宫颈癌的检出率为45.56/10 万,早期诊断率为87.64%。宫颈癌前病变和宫颈癌的HPV16、18及混合感染占70.79%。 结论 该地区高危型HPV阳性率、宫颈癌前病变及宫颈癌检出率均较高,宫颈癌筛查异常者细胞学及阴道镜转诊率较低,提示该地区存在更高的宫颈癌发病风险。
Objective To understand the positive screening results and the infection characteristics of high-risk human papillomavirus (HPV) in Huaiji County,Guangdong Province,in the two years of the free standardization testing for rural women's “two cancers”. Methods The cervical cancer screening results of 35~64 year-old women with rural household registration who volunteered to participate in the “two cancers” free testing for rural women in the region were analyzed. High-risk HPV testing was used as the primary screening method for cervical cancer. The results of HPV16 and 18 positive patients were directly referred to colposcopy. If other high-risk HPV was positive,thin-layer cervical fluid-based cytology(TCT) was perform on those patients,whose TCT result severer than atypical squamous cells of undetermined significance (ASC-US) were referred to colposcopy,and those with suspicious or abnormal colposcopy results were referred to histopathological examination. Results The total positive detection rate of high-risk HPV was 9.35%. The positive rates of HPV16,18 and other high-risk HPV were 0.70%,0.32% and 7.72% respectively,mixed infection rate was 0.61%. The age group with the highest overall positive rate of high-risk HPV is 60-64 years old,and the rate is 11.22%. The referral rate for cytology was 65.63%,and the referral rate for colposcopy was 61.23%. The positive rate of cervical precancerous lesions was 323.03/100 000,the positive rate of cervical cancer was 45.5/100 000,and the early diagnosis rate was 87.64%.HPV16,18 and HPV mixed infections of cervical precancerous lesions and cervical cancer accounted for 70.79%.Conclusions The positive rate of high-risk HPV,cervical precancerous lesions and cervical cancer positive rate were high in this area. The being referred rate of cytology and colposcopy in cervical cancer screening was low,suggesting that there was a higher incidence of cervical cancer in this area risk.
论著

新生儿单纯疱疹病毒中枢神经系统感染病例报告并文献复习

Herpes simplex virus central nervous system infection in neonate:a case report and literature review

:100-104
 
目的 报道1例新生儿单纯疱疹病毒中枢神经系统感染病例,并通过文献回顾和复习,提高临床上对此类少见病的认识,减少该病的误诊、漏诊。方法 回顾性分析1例新生儿单纯疱疹病毒中枢神经系统感染患儿的发病、诊断和治疗过程,结合以往的文献报道,总结该病的临床表现和诊治要点。结果 回顾文献显示:新生儿单纯疱疹病毒中枢神经系统感染非常少见。病死率高,存活者大多存在神经系统不良结局。本例为14天大新生儿,因发热入院,原因未明,入院即予阿昔洛韦抗病毒治疗取得良好疗效,随访至今(3月大),未见神经系统异常表现。提示及早有效的抗病毒治疗是影响预后的关键因素。结论 新生儿单纯疱疹病毒中枢神经系统感染临床无特异性表现,此病少见。尽早、足程的抗病毒治疗,可明显改善患儿的预后。对于不明原因发热的新生儿(特别是社区获得者),早期经验性予以阿昔洛韦抗病毒治疗,利大于弊。
Objective To report a case of herpes simplex virus central nervous system infection in a neonate and to review literatures about this disease, and to improve clinical understanding of this rare disease and reduce misdiagnosis and missed diagnosis. Methods The clinical manifestation,diagnosis and treatment of the patient with herpes simplex virus central nervous system infection were analyzed.The epidemiology,clinical manifestation and key points of diagnosis were summarized from literature review. Results Literature review showed that: neonatal herpes simplex virus central nervous system infection is very rare. The mortality rate is high, and most of the survivors have adverse neurological outcomes. This case is a fourteen days newborn who was admitted to the hospital due to fever for unknown reasons. He was given acyclovir antiviral therapy immediately after admission and achieved good results. Follow-up of 3 months showed no neurological abnormalities. It suggested that early and effective antiviral therapy is a key factor affecting the prognosis. Conclusion Neonatal herpes simplex virus central nervous system infection has no specific clinical manifestations, and this disease is rare. Early, full-course of antiviral therapy can greatly improve the prognosis of children. For newborns with unexplained fever (especially those obtained in the community), early empirical antiviral treatment with acyclovir is more beneficial than harmful.
论著

艾滋病继发真菌感染患者病情的临床特点与治疗措施分析

Analysis of clinical characteristics and treatments of AIDS secondary fungal infection

:37-39
 
目的 探讨艾滋病继发真菌感染患者病情的临床特点与治疗措施。方法 选取2019年4月—2020年4月我院收治的艾滋病继发真菌感染患者90例,对所有患者的病情特点进行分析,并及时采取有效地治疗措施。分析患者真菌感染部位、病情临床特点、治疗效果。结果 患者真菌感染部位中,排在前三位的为口腔、肺、食道,占比为44.4%(40/90)、30.0%(27/90)、23.3%(21/90);90例患者中,感染真菌排在前三位的为白色念珠菌、马尔尼菲青霉菌、新型隐球菌,占比为36.7%(33/90)、24.4%(22/90)、16.7%(15/90);90例患者中,显效32例(35.5%)、有效46例(51.1%)、无效12例(13.4%),有效率为86.6%(78/90)。结论 艾滋病继发真菌感染患者中,感染的主要部位主要为口腔、肺、食道,其中感染的真菌主要有白色念珠菌、马尔尼菲青霉菌、新型隐球菌。对患者及时进行有效地抗逆转录病毒治疗可以降低患者死亡率,提高治疗效果。
Objective To explore the clinical characteristics and treatments of AIDS secondary fungal infection. Methods A total of 90 patients with secondary fungal infection of AIDS admitted to our hospital from April 2019 to April 2020 were selected, and the characteristics of all patients were analyzed, and effective treatment measures were taken in time. The sites of fungal infection, clinical characteristics and therapeutic effects were analyzed. Results The top three fungal infection sites were oral cavity, lung and esophagus, accounting for 44.4% (40/90), 30.0% (27/90) and 23.3% (21/90). Among the 90 patients, candida albicans, penicillium marneffei and cryptococcusneoforme ranked the top three, accounting for 36.7% (33/90), 24.4% (22/90) and 16.7% (15/90). Of the 90 patients, 32 had obvious effects (35.5%), 46 had effective effects (51.1%) and 12 had no effects (13.4%), and the effective rate was 86.6% (78/90). Conclusion In the patients with secondary fungal infection of AIDS, the main sites of infection were oral cavity, lung and esophagus, in which the main infected fungi were candida albicans, penicillium marneffei and cryptococcus neofordii. Timely and effective antiretroviral therapy can reduce the mortality and improve the treatment effect.
论著

核苷类似物治疗宫颈人乳头瘤病毒感染的疗效

Nucleoside analogues therapy for cervical high-risk HPV infection

:11-16
 
目的 评价口服核苷类似物富马酸丙酚替诺福韦治疗宫颈持续性高危型人乳头瘤感染患者的疗效。方法 本回顾性研究中,将同一亚型高危型人乳头瘤病毒感染超过1年患者随机分为两组,治疗组给予口服富马酸丙酚替诺福韦,25 mg,每天一次,连续3个月;对照组给予宣教说明,无特殊处理。于入组后第3个及第6个月随诊。检测患者宫颈人乳头瘤病毒感染的变化,同时观察宫颈细胞学、阴道镜Reid评分及宫颈组织病理学变化。结果 宫颈持续性高危型人乳头瘤病毒感染者共82例,分为两组:治疗组42例,对照组40例。均完成随访。在治疗结束时、治疗结束后3个月,治疗组清除人乳头瘤病毒的有效率分别为 52.38% 和 61.90%,优于对照组20.00%(P<0.05)和30.00% (P<0.05);治疗结束时、治疗结束后3个月,治疗组细胞学异常的缓解率分别为66.67%和77.78%,优于对照组22.22%(P<0.05)和33.33%(P<0.05);治疗组中Reid评分3分及其以上者例数较对照组少(2 vs 10,P<0.05),且Reid评分较基线明显下降(P<0.05),对照组Reid评分无显著变化(P>0.05)。6个月时治疗组中宫颈上皮内瘤变I级者组织学缓解率优于对照组(72.72% vs 35.00%,P<0.05)。随访期间无严重不良反应。结论 口服富马酸丙酚替诺福韦可有效清除宫颈持续性高危型人乳头瘤病毒感染,且安全、临床可行。
Objective To investigate the clinical efficacy of nucleoside analogues Tenofovir Alafenamide (TAF) therapy for cervical high-risk HPV (HR-HPV) infection. Methods In this prospective study, a total of 82 patients with persistent cervical HR-HPV infection were randomly divided into two groups. The treatment group (42 patients) administered orally TAF (25mg, once daily, 3 months). The control group (40 patients) received no treatment. All patients were followed up for 6 months. HPV testing, ThinPrep cytology test (TCT), and Reid colposcopic index (RCI) grading were performed for both groups. Results HR-HPV remission rates were 52.38% and 61.9% in the treatment group at the 3-and 6-month follow-up, respectively, whereas 20% and 30% in the control group at the 3-and 6-month follow-up visits. Conversion rates of abnormal TCT results were 66.67% and 77.78% in the treatment group at two follow-up visits. In contrast, the control group showed remission rates at 22.2% and 33.3%, respectively. There were 2 and 10 patients with grade of 3-4 or higher at the treatment group and the control group at the 6-month visit, respectively. RCI scoring was declining obviously at 6 months in the treatment group (P<0.05), whereas the control group showed no significantly difference. 16 of 22 (72.72%) patients with CINⅠin the treatment group were alleviated at 6-month visit compared to 35% in the control group(P<0.05). No serious adverse events happened during the treatment and follow up. Conclusion Tenofovir alafenamide is an effective, safe and accessible treatment for cervical HR-HPV infection.
论著

继发性肺结核合并肺部真菌感染的临床特点及危险因素分析

Clinical characteristics and risk factors of secondary pulmonary tuberculosis complicated with pulmonary fungal infection

:79-83
 
目的 探讨继发性肺结核合并肺部真菌感染的临床特点及相关高危因素。方法 收集广州市胸科医院2017年7月—2019年10月收治的继发性肺结核患者资料,病程均大于3个月,分为真菌感染组106例和非真菌感染组100例进行回顾性分析。结果 单因素分析结果显示,合并肺部其他疾病、非初治、咯血、空洞、应用广谱抗生素>l周、侵袭性操作存在统计学差异(P<0.05)。Logistic多因素分析结果显示,广谱抗生素使用>l周、侵袭性操作为真菌感染的独立危险因素(P<0.05)。结论 对于应用广谱抗生素、进行侵袭性操作的肺结核患者应警惕真菌感染风险,及早预防及诊治。
Objective To investigate the clinical characteristics and related high risk factors of secondary pulmonary tuberculosis complicated with pulmonary fungal infection. Methods Data of patients with secondary tuberculosis admitted to Guangzhou Chest Hospital from July 2017 to October 2019 were collected. All patients with a course of disease longer than 3 months were divided into the fungal infection group (n =106) and the non-fungal infection group (n =100) for retrospective analysis. Results Univariate analysis results showed that there were statistical differences in combined other pulmonary diseases, non-initial treatment, hemoptysis, cavity, application of broad-spectrum antibiotic > for 1 week, and invasive operation (P<0.05). Logistic multivariate analysis showed that >1 week of broad-spectrum antibiotics and invasive procedures were independent risk factors for fungal infection (P<0.05). Conclusion Patients with tuberculosis who are treated with broad-spectrum antibiotics and invasive procedures should be alert to the risk of fungal infection, early prevention and treatment should be undertaken.
论著

老年急性缺血性脑卒中并发肺部感染的危险因素

The risk factors of pulmonary infection in elderly patients with acute ischemic stroke

:28-31
 
目的 探讨老年急性缺血性脑卒中并发肺部感染患者的临床特征和相关危险因素。方法 采用回顾性研究方法,选择2017年7月— 2019年10月深圳市第二人民医院神经内科收治的1 113例老年急性缺血性脑卒中患者,其中卒中并发肺部感染患者(108 例)纳入感染组,未并发肺部感染患者(1 005例)纳入对照组。以单因素对比分析两组患者的临床资料,采用 Logistic多因素回归分析方法分析合并肺部感染的高危因素。结果 单因素分析提示两组年龄(尤其是高龄患者)、住院天数、房颤、脑梗死史、慢性肺疾病、吞咽困难、言语不清、意识障碍差异有统计学意义(P <0.05)。多因素 Logistics 回归分析显示,高龄(≥80岁)、住院天数、脑梗死史、吞咽困难、言语不清、意识障碍与老年急性缺血性脑卒中并发肺部感染密切相关。结论 老年急性缺血性脑卒中并发肺部感染的独立危险因素主要是高龄(≥80 岁)、住院天数、脑梗死史、吞咽困难、言语不清、意识障碍,临床应高度重视。
Objective Objective To investigate the clinical characteristics and risk factors of elderly patients with acute ischemic stroke complicated with pulmonary infection. Methods A retrospective study was conducted on 1 113 elderly patients with acute ischemic stroke admitted to the department of neurology, Shenzhen Second People's Hospital from July 2017 to October 2019. Among them, 108 patients with stroke complicated with pulmonary infection were included in the infection group and 1 005 patients without concurrent pulmonary infection were included in the control group. The clinical data of the two groups were analyzed by single factor comparison, and the risk factors for pulmonary infection were analyzed by logistic multiple factor regression analysis. Results Single factor analysis showed there were statistically significant differences between the two groups in age (especially elderly patients), length of stay in hospital, atrial fibrillation, history of cerebral infarction, chronic pulmonary disease, dysphagia, slurred speech, and disturbance of consciousness (P <0.05). Multi-factor logistic regression analysis showed that old age (≥80 years old), length of stay in hospital, history of cerebral infarction, dysphagia, slurred speech, and disturbance of consciousness were closely related to pulmonary infection in elderly patients with acute ischemic stroke. Conclusion The independent risk factors of acute ischemic stroke complicated with pulmonary infection in the elderly mainly include old age (≥80 years old), length of stay in hospital, history of cerebral infarction, dysphagia, slurred speech and disturbance of consciousness, which should be paid more attention to clinically.
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