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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7 d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。

英文摘要:

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, SAI immunosuppressive occurrence and there is a significant correlation.

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