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目的探讨血清钠在评估卒中相关性肺炎(SAP)预后中的价值。方法选择2009年7月—2012年5月在我院神经内科住院治疗的SAP患者47例,根据患者的预后分为好转组37例和死亡组10例。根据患者血清钠水平分为重度低钠组7例、中度低钠组11例、轻度低钠组16例和非低钠组13例。所有患者在入院肺炎诊断明确后的24 h内抽取清晨空腹抗凝血检测血常规及血清钠,同时记录患者的生命体征、白细胞计数、急性生理与慢性健康状况(APACHEⅡ)评分。结果好转组患者白细胞计数、APACHEⅡ评分和血清钠水平均低于死亡组(P<0.05);亚组分析显示,随着血清钠水平降低,SAP的病死率升高,组间比较差异均有统计学意义(P<0.05)。结论 SAP伴低钠血症者,APACHEⅡ评分高,病死率高。血清钠水平可能作为SAP患者预后的重要临床评估指标之一。
Objective To investigate the value of serum sodium in assessing the prognosis of stroke-associated pneumonia (SAP). Methods Forty-seven SAP patients hospitalized in our department of neurology from July 2009 to May 2012 were divided into improved group (n = 37) and death group (n = 10) according to the prognosis of patients. According to the level of serum sodium, patients were divided into severe hyponatremia group (n = 7), moderate hyponatremia group (n = 11), mild hyponatremia group (n = 16) and non-hyponatremia group (n = 13) All patients were taken fasting anticoagulant blood samples and serum sodium within 24 hours after diagnosis of pneumonia in hospital, and vital signs, white blood cell count, acute physiology and chronic health status (APACHEⅡ) scores were recorded. Results In the remission group, the white blood cell count, APACHEⅡscore and serum sodium level were lower than those in the death group (P <0.05). Subgroup analysis showed that with the decrease of serum sodium level, the mortality rate of SAP increased, with statistically significant differences Significance (P <0.05). Conclusion SAP patients with hyponatremia, APACHE Ⅱ score high, high mortality. Serum sodium level may be one of the important clinical evaluation indicators for the prognosis of patients with SAP.