J Cereb Blood Flow Metab:卒中诱导的免疫抑制和吞咽困难与卒中相关肺炎独立相关

2020-07-29 MedSci原创 MedSci原创

脑卒中相关肺炎是脑卒中后常见的并发症,与不良结局有关。吞咽困难是脑卒中相关肺炎的已知危险因素,但现有的证据表明,脑卒中诱导的免疫抑制状态增加了脑卒中相关肺炎的易感性。本研究旨在通过研究单细胞HLA-D

卒中相关肺炎是脑卒中后常见的并发症,与不良结局有关。吞咽困难是脑卒中相关肺炎的已知危险因素,但现有的证据表明,脑卒中诱导的免疫抑制状态增加了脑卒中相关肺炎的易感性。本研究旨在通过研究单细胞HLA-DR表达作为免疫抑制标志物以及炎症(白细胞介素-6)和感染(脂多糖结合蛋白)的生物标志物的预测特性,证实卒中诱导的免疫抑制综合征与卒中相关性肺炎独立于吞咽困难。

 

采用前瞻性的多中心研究设计,在德国和西班牙有11个研究点进行,纳入486名急性缺血性卒中患者。每天进行卒中相关肺炎、吞咽困难和生物标志物的筛查

 

结果显示,脑卒中相关肺炎的频率为5.2%。在多变量回归分析中,吞咽困难和单核细胞HLA-DR降低是脑卒中相关肺炎的独立预测因素。肺炎的比例在单核细胞HLA-DR较高分位数(≥21,876 mAb/细胞)的0.9%和较低分位数(≤12,369 mAb/细胞)的8.5%之间。在存在吞咽困难的情况下,肺炎的比例分别增加到5.9%和18.8%。没有吞咽困难和单细胞HLA-DR表达正常的患者没有卒中相关的肺炎风险。

 

综上所述,该研究结果表面,吞咽困难和卒中诱导的免疫抑制综合征是卒中相关肺炎的独立风险因素。筛查免疫抑制和吞咽困难可能有助于识别脑卒中相关性肺炎的高风险患者。

 

原始出处:

 

Sarah HoffmannHendrik Harms,et al., Stroke-induced immunodepression and dysphagia independently predict stroke-associated pneumonia - The PREDICT study. J Cereb Blood Flow Metab. 2017 Dec;37(12):3671-3682.doi: 10.1177/0271678X16671964. 

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1888184, encodeId=1ca51888184a0, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Sun Dec 27 12:31:01 CST 2020, time=2020-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896711, encodeId=98381896e111d, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Thu Jul 30 05:31:01 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1318625, encodeId=26ad131862578, content=<a href='/topic/show?id=25eb391692f' target=_blank style='color:#2F92EE;'>#吞咽困难#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39169, encryptionId=25eb391692f, topicName=吞咽困难)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5eee468, createdName=zxl729, createdTime=Fri Jul 31 10:31:01 CST 2020, time=2020-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=805170, encodeId=af778051e08d, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200730/0796f7e875f34e9fa3ee1d7b9da19c2b/711d476a19144354a05a422d24d495ec.jpg, createdBy=2d425268433, createdName=新斯的明, createdTime=Thu Jul 30 11:05:11 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026681, encodeId=ee1b102668165, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Wed Jul 29 22:31:01 CST 2020, time=2020-07-29, status=1, ipAttribution=)]
    2020-12-27 guojianrong
  2. [GetPortalCommentsPageByObjectIdResponse(id=1888184, encodeId=1ca51888184a0, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Sun Dec 27 12:31:01 CST 2020, time=2020-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896711, encodeId=98381896e111d, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Thu Jul 30 05:31:01 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1318625, encodeId=26ad131862578, content=<a href='/topic/show?id=25eb391692f' target=_blank style='color:#2F92EE;'>#吞咽困难#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39169, encryptionId=25eb391692f, topicName=吞咽困难)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5eee468, createdName=zxl729, createdTime=Fri Jul 31 10:31:01 CST 2020, time=2020-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=805170, encodeId=af778051e08d, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200730/0796f7e875f34e9fa3ee1d7b9da19c2b/711d476a19144354a05a422d24d495ec.jpg, createdBy=2d425268433, createdName=新斯的明, createdTime=Thu Jul 30 11:05:11 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026681, encodeId=ee1b102668165, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Wed Jul 29 22:31:01 CST 2020, time=2020-07-29, status=1, ipAttribution=)]
    2020-07-30 一闲
  3. [GetPortalCommentsPageByObjectIdResponse(id=1888184, encodeId=1ca51888184a0, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Sun Dec 27 12:31:01 CST 2020, time=2020-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896711, encodeId=98381896e111d, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Thu Jul 30 05:31:01 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1318625, encodeId=26ad131862578, content=<a href='/topic/show?id=25eb391692f' target=_blank style='color:#2F92EE;'>#吞咽困难#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39169, encryptionId=25eb391692f, topicName=吞咽困难)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5eee468, createdName=zxl729, createdTime=Fri Jul 31 10:31:01 CST 2020, time=2020-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=805170, encodeId=af778051e08d, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200730/0796f7e875f34e9fa3ee1d7b9da19c2b/711d476a19144354a05a422d24d495ec.jpg, createdBy=2d425268433, createdName=新斯的明, createdTime=Thu Jul 30 11:05:11 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026681, encodeId=ee1b102668165, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Wed Jul 29 22:31:01 CST 2020, time=2020-07-29, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1888184, encodeId=1ca51888184a0, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Sun Dec 27 12:31:01 CST 2020, time=2020-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896711, encodeId=98381896e111d, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Thu Jul 30 05:31:01 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1318625, encodeId=26ad131862578, content=<a href='/topic/show?id=25eb391692f' target=_blank style='color:#2F92EE;'>#吞咽困难#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39169, encryptionId=25eb391692f, topicName=吞咽困难)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5eee468, createdName=zxl729, createdTime=Fri Jul 31 10:31:01 CST 2020, time=2020-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=805170, encodeId=af778051e08d, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200730/0796f7e875f34e9fa3ee1d7b9da19c2b/711d476a19144354a05a422d24d495ec.jpg, createdBy=2d425268433, createdName=新斯的明, createdTime=Thu Jul 30 11:05:11 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026681, encodeId=ee1b102668165, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Wed Jul 29 22:31:01 CST 2020, time=2020-07-29, status=1, ipAttribution=)]
    2020-07-30 新斯的明

    谢谢分享

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1888184, encodeId=1ca51888184a0, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Sun Dec 27 12:31:01 CST 2020, time=2020-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896711, encodeId=98381896e111d, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Thu Jul 30 05:31:01 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1318625, encodeId=26ad131862578, content=<a href='/topic/show?id=25eb391692f' target=_blank style='color:#2F92EE;'>#吞咽困难#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39169, encryptionId=25eb391692f, topicName=吞咽困难)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5eee468, createdName=zxl729, createdTime=Fri Jul 31 10:31:01 CST 2020, time=2020-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=805170, encodeId=af778051e08d, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200730/0796f7e875f34e9fa3ee1d7b9da19c2b/711d476a19144354a05a422d24d495ec.jpg, createdBy=2d425268433, createdName=新斯的明, createdTime=Thu Jul 30 11:05:11 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026681, encodeId=ee1b102668165, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Wed Jul 29 22:31:01 CST 2020, time=2020-07-29, status=1, ipAttribution=)]
    2020-07-29 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

相关资讯

Circulation:冠脉搭桥术中结扎左心耳对房颤患者短期预后的影响

心房颤动导致的卒中,90%以上的血栓起源于左心耳,封堵左心耳是否可减少房颤患者的卒中率?

Stroke:西洛他唑用于卒中和认知功能下降的二级预防

西洛他唑可以有效长期预防复发性卒中,而不会增加出血的风险。但是,大多数与亚太地区患者有关的试验以及西方国家的更多试验应评估其对认知功能下降、功能结局和耐受性的影响。

类似于急性冠脉综合征及中风,你会想起该病吗?

嗜酸性肉芽肿性多血管炎,也称为Churg-Strauss综合征(churg-strauss syndrome,CSS),以哮喘、嗜酸性粒细胞增多及血管炎为临床表现的、累及多器官的罕见疾病。

Neurology:服用达比加群卒中患者的溶栓治疗

达比加群酯(达比加群)是一种直接凝血酶抑制剂,已被证明可预防心房颤动患者的卒中。伊达鲁珠单抗(Idarucizumab)是一种人源化单克隆抗体片段,旨在逆转达比加群的抗凝作用。伊达鲁珠单抗与达比加群的

进口干细胞治疗卒中的临床试验在北京天坛医院启动

2020年7月6日,九芝堂美科与北京天坛医院正式签署临床试验合作协议,标志着中国首个进口干细胞新药临床试验即将启动,适应症为“缺血性卒中”。

Neurology:卒中和心脏以上动脉粥样硬化患者的抗血栓治疗

与抗血小板治疗相比,抗凝治疗的卒中和心脏以上动脉粥样硬化患者没有缺血性卒中复发的风险,而大出血风险增加。