卒中相关性肺炎的防治-刘蓉怡介绍.pptVIP

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卒中相关性肺炎的防治-刘蓉怡介绍.ppt

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* Figure 2. Risk factors for poststroke complications. OHS indicates Oxford Handicap Score,37 dichotomized into 0 to 2 (independent) and 3 to 5 (dependent); TACS, total anterior circulation syndrome (hemorrhagic strokes excluded); GCS, Glasgow Coma Scale; CI, confidence interval; and OR, odds ratio. *Previous history of atrial fibrillation and/or atrial fibrillation on admission electrocardiogram; occurring within 7 days of stroke. * * * * * * Figure 3. Stroke induces increased apoptosis in lymphoid organs. Spleen and thymus from untreated SV129/J mice (control) and sham or MCAO mice were collected 12 h after surgery. Splenocytes (a) and thymocytes (b) were isolated and investigated for apoptosis by annexin V labeling and flow cytometry. Lymphocyte subpopulations were determined by staining with mAbs against cell-type–specific surface markers. Data are shown as mean SD. *, results differed from the control group; *, P 0.05; **, P 0.01; ***, P 0.001; #, results differed from the sham-operated group; #, P 0.05; ##, P 0.01; ###, P 0.001. Mann-Whitney U test, n 8 per group. (c) Thymic tissue sections from sham- and MCAO-treated mice were stained with HE (top) or examined by the fluorescent TUNEL method (bottom). Thymi from MCAO mice showed many apoptotic cells with typical features of nuclear condensation and fragmentation (HE; 400). Note also the high number of TUNEL cells (bright red nuclei) in the thymus cortex from MCAO animals as compared with sham mice. 100. * * * 卒中相关性肺炎的防治卒中后并发症累积比率（30天） R.J. Davenport,et al. Stroke 1996; 27: 415 - 420. 卒中后并发症累积比率（1年） 50 40 30 20 10 1 2 3 4 5 6 7 8 9 10 11 12 Pain Falls Depression Chest infection UTI Pressure sore Recurrent stroke DVT Cumulative proportion (%) Langhorne P，et al. Stroke 2000; 31:1223-9. 卒中相关性肺炎(stroke-associated pneumonia,SAP) 原先无肺部感染的卒中患者罹患的感染性肺实质（含肺泡壁、即广义的肺间质）炎症。卒中后胸部影像学发现或进展性病变，同时合并两个或以上临床症状： 1、体温≥38℃； 2、咳嗽咳痰，原呼吸道疾病加重，或伴胸痛； 3、肺实质体征和（或）湿啰音； 4、白细胞≥10×1