卒中相关感染的危险因素及其与免疫抑制的相关性分析

目的：探讨卒中相关感染的危险因素及其与免疫抑制的相关性。方法：选取2010年4月至2013年7月我院收治的164名急性卒中患者的临床资料，依据入院7d内是否存在感染将其分为感染组和非感染组。对两组的临床资料、及淋巴细胞及T淋巴细胞亚群的监测结果分别进行单因素分析及多因素Logistic回归分析。结果：164例急性卒中患者在发病后7天内64例出现SAI，SAI的发生率为39．02％，平均感染时间为2．58±0．94天。单因素分析发现，两组患者的意识障碍、吞咽困难、留置胃管、留置导尿、NIHSS评分等因素相比，差异均具有统计学意义（P〈0．05）。感染组的淋巴细胞计数、淋巴细胞百分比及CD3＋、CD4、CD8＋T淋巴细胞水平均明显低于非感染组（P〈0．05）。多因素Logistic回归分析可知，吞咽困难、第3天NIHSS评分、CD4＋T淋巴细胞成为影响SAI发生的独立危险因素（P〈0．05）。结论：吞咽困难、第3天NIHSS评分、CD4＋T淋巴细胞是影响脑卒中相关感染发生的独立危险因素，sAI的发生与免疫抑制存在显著的相关性。

Risk Factors of Stroke-Related Infection and Its Correlation with Immune Suppression

Objective： To explore the risk factors of stroke-related infection and its correlation with immune suppression. Methods： April 2010 to July 2013 in our hospital 164 patients with acute stroke clinical data, based on the existence of hospital infection within 7 d infection will be divided into groups and non-infected group. The clinical data of the two groups, and lymphocyte and T lymphocyte subsets monitoring results were analyzed by univariate analysis and multivariate Logistic regression analysis. Results： 164 patients with acute stroke patients within 7 days after the onset of 64 cases occurred SAI, SAI incidence rate of 39.02%, the average infection time was 2.58 ± 0.94 days. Univariate analysis found that two groups of patients of consciousness, difficulty swallowing, indwelling stomach tube, indwelling catheterization, NIHSS score and other factors, the differences were statistically significant （P〈0.05）. Infection of lymphocyte count, percentage of lymphocytes and CD3＋, CD4＋, CD8＋ T lymphocytes were significantly lower than non-infected group （P〈0.05）. Multivariate Logistic regression analysis, difficulty swallowing, the first three days NIHSS score, CD4＋ T lymphocytes an impact on stroke-related infection were independent risk factors （P〈0.05）. Conclusion： Difficulty swallowing, the first three days NIHSS score, CD4＋T lymphocytes are the effects of stroke-related infection is an independent risk factor, SA1 immunosuppressive occurrence and there is a significant correlation.