超早期血肿扩大与卒中相关性肺炎及短期预后的相关性研究

Correlation Study of Ultra-Early Hematoma Growth with Stroke-Associated Pneumonia and Short-Term Prognosis

摘要: 目的：本研究旨在探讨急性脑出血患者并发卒中相关性肺炎(stroke-associated pneumonia, SAP)的危险因素。方法：选取2022年8月至2024年3月于安徽医科大学第二附属医院神经内科就诊的急性脑出血连续性病例，以是否合并SAP为分组依据，分为SAP组和非SAP组，采用单因素和多因素logistic回归分析SAP的相关危险因素，比较两组临床参数，并采用受试者工作特征(ROC)曲线评价超早期血肿扩大(ultra-early Hematoma Growth, uHG)对于SAP的预测价值。结果：多因素logistic回归分析显示，年龄、住院时间、基线GCS评分、uHG是SAP的独立危险因素(P < 0.05)。ROC曲线分析结果表明，uHG预测SAP的曲线下面积为0.778 (P < 0.001)，其最佳临界值为4.08，灵敏度为81.5%，特异性为58%。结论：超早期血肿扩大与原发性脑出血患者卒中相关性肺炎风险增加和90天不良预后相关，具有一定的预测价值。

Abstract: Objective: To investigate the risk factors of stroke-associated pneumonia (SAP) in patients with intracerebral hemorrhage (ICH) and assess its clinical implications. Methods: Patients with ICH were admitted to the Department of Neurology at the Second Affiliated Hospital of Anhui Medical University from August 2022 to March 2024. According to whether patients had SAP, they were stratified into SAP and non-SAP cohorts. Clinical characteristics between these two groups were contrasted, and univariate and multivariate logistic regression analyses were applied to identify SAP-associated risk factors. The predictive value of ultra-early hematoma growth (uHG) for SAP was evaluated using receiver operating characteristic (ROC) curve analysis. Results: Multiple logistic regression analysis showed that age, length of stay, GCS score and uHG were independent risk factors for SAP (P < 0.05). ROC curve analysis revealed that the area under the curve predicted by uHG for SAP was 0.778 (P < 0.001) with an optimal cut-off of 4.08, a sensitivity of 81.5% and a specificity of 58%. Conclusion: uHG was linked to an augmented risk of SAP and 90-day poor outcomes in patients with primary ICH, and has certain predictive value.