Stroke:急性卒中患者入院时胸部计算机断层扫描肺部感染征象与肺炎或死亡相关

2020-05-21 MedSci原创 MedSci原创

在急性缺血性卒中患者中,约有七分之一的患者在卒中发病后数小时内就出现了肺部感染的影像学征象,这些患者发生肺炎或死亡的风险较高。他们应尽早使用抗生素可能会获得更好的结局。

急性卒中患者肺炎的发生与功能预后差和死亡风险增加有关。近日,心血管疾病领域权威杂志Stroke上发表了一篇研究文章,研究人员旨在评估肺炎发生之前胸部计算机断层扫描(CT)上肺部感染征象存在情况及其后果。

连续就诊的200例急性缺血性卒中患者在症状发作后24小时内接受了从颅骨到膈肌(包括胸部CT)的CT血管造影检查,研究人员评估了CT上是否存在结节、玻璃样混浊和树上有芽的肺部感染CT征象,并采用Logistic回归评估了其与前7天临床上明显的肺炎发展和死亡以及90天后功能结局之间的关系。

从卒中发病到CT检查的中位时间为151分钟(四分位间距为84-372)。入院时有30例患者(15%)存在感染的影像学征象,前7天有22例(11.0%)患者被临床诊断为肺炎。具有影像学感染迹象的患者发生临床肺炎的风险较高(30% vs. 7.6%;校正后的比值比为4.2 [95%CI为1.5-11.7];P=0.006),并且7天时死亡风险较高(调整后的比值比为3.7 [95%CI为1.2-11.6];P=0.02),而90天则不然。

由此可见,在急性缺血性卒中患者中,约有七分之一的患者在卒中发病后数小时内就出现了肺部感染的影像学征象,这些患者发生肺炎或死亡的风险较高。他们应尽早使用抗生素可能会获得更好的结局。

原始出处:

Jeroen C. de Jonge,et al.Signs of Pulmonary Infection on Admission Chest Computed Tomography Are Associated With Pneumonia or Death in Patients With Acute Stroke.stroke.2020.https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.028972

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    2020-06-24 bioon14
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    2020-05-21 qingfengqishi5

    学习了,学习了

    0

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    2020-05-21 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

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