实用医学杂志 ›› 2022, Vol. 38 ›› Issue (17): 2170-2180.doi: 10.3969/j.issn.1006⁃5725.2022.17.010

• 临床研究 • 上一篇    下一篇

急性缺血性脑卒中患者口腔清洁度异常与 卒中相关性肺炎的影响因素及关系 

杨晓华1 陈惠娟1 何娟2 张娟3 胡婷婷3 杨晓丽1 王青1 陶希1,3,4    

  1. 1 南方医科大学珠江医院神经内科(广州 510282);湖南省人民医院(湖南师范大学附属第一医院) 2 神经外科,3 神经康复科(长沙 410016);4 湖南省脑血管病康复临床医学研究中心(长沙 410016)

  • 出版日期:2022-09-10 发布日期:2022-09-10
  • 通讯作者: 陶希 E⁃mail:taoxi567@hunnu.edu.cn
  • 基金资助:
    广东省科技计划项目(编号:2020A0505100037);广东省医学科学研究基金(编号:C2019120);湖南省高级卫生人才“225”工 程 计划和湖南省卫生健康委科研项目(编号 :202203102866)

Mutually actingrisk roles of oral cleanliness and stroke ⁃associated pneumonia in patients with acute isch⁃ emic stroke:A case ⁃control study

YANG Xiaohua*,CHEN Huijuan,HE Juan,ZHANG Juan,HU Tingting, YANG Xiaoli,WANG Qing,TAO Xi.    

  1. Department of Neurology,Zhujiang Hospital,Southern Medical University Guangzhou 510282,China

  • Online:2022-09-10 Published:2022-09-10
  • Contact: TAO Xi E⁃mail:taoxi567@hunnu.edu.cn

摘要:

目的 分析急性缺血性脑卒中患者口腔卫生与卒中相关性肺炎(SAP)的影响因素及关系。 方法 纳入 331 例急性缺血性脑卒中患者,收集患者基本资料、神经功能缺损评分和口腔卫生习惯等信 息。根据口腔卫生状态及是否发生 SAP 分组比较,以二元 logistic 回归分析口腔清洁度异常和 SAP 的危险 因素。结果 回归分析显示,SAP(OR = 2.219,P = 0.026)、龋齿(OR = 1.292,P = 0.005)和年龄(OR = 1.030,P = 0.006)是脑卒中患者口腔清洁度的独立危险因素,而 Barthel 指数评分(OR = 0.986,P = 0.019 是其保护因素;BOAS 评分(OR = 1.972,P < 0.001)与 NIHSS 评分(OR = 1.322,P < 0.001)是 SAP 的独立危 险因素。结论 急性缺血性脑卒中患者口腔清洁度异常与 SAP 互为独立危险因素,保护口腔卫生也许有 助于 SAP 预防。

关键词:

缺血性脑卒中, 口腔卫生, 卒中相关性肺炎, 危险因素, 龋齿, 高龄, 神经功 能缺损, 日常生活活动能力

Abstract:

Objective To analyze the influencing factors and correlation of oral hygiene and stroke⁃associ⁃ ated pneumonia(SAP)in patients with acute ischemic stroke. Methods We performed a cross⁃sectional study by recruiting 331 patients with acute ischemic strokefrom two medical centers. A series of assessments were performed to evaluate the neurological status and habits of oral hygiene. Univariate analyses were performed firstly on the conditions of oral hygiene and occurrence of SAP. Multiple logistic regression analyses were conducted to find risk factors of oral cleanness and SAP in the stroke patients. Results After adjusting the confounders,multivariable logistic regression analysis showed that SAP(OR = 2.219,P = 0.026),dental caries(OR = 1.292,P = 0.005)and age(OR = 1.030,P = 0.006)were the risk factors for oral cleanness in those stroke patients,while the score of Barthel index(OR = 0.986,P = 0.019)was a protective factor. BOAS score(OR = 1.972,P < 0.001)and NIHSS score(OR = 1.322,P < 0.001)were the risk factors for SAP. Conclusion The abnormality of oral cleanness and SAP are the and mutually acting risk factors in patients with acute ischemic stroke. Protecting oral hygiene may be helpful for SAP prevention.

Key words:

ischemicstroke, oral hygiene, stroke?associated pneumonia, neurological deficit, risk factors, dental caries, aging, activities of daily living