Risk Factors Of Stroke-associated Infection And Its Correlation With Stress Response And Cell Immunity

Part1: Analysis of risk factors with stroke-associated infectionObjective: To examine risk factors for stroke-associated infection, so as to provide theoretical basis for clinical treatment.Methods : In our prospective study,114 patients were enrolled consecutively and ad-mitted to hospital within 24h after symptoms onset.Investigate patients'previous me- dical history ,record their basic situation on admission. The patients with stroke were divided into infection(n=45) and non-infection(n =69)groups according to whether the infection occurred or not within one week after symptom onset. Univariate predictions and logistic regression analysis were used to find the risk factors for SAI.Result: 45 cases occur infection on (2.18±1.4)day after admission, the rate is 39.5%.Single factor analysis vomits,conscious disturbance and dyaphagia on admission, the score of NIHSS on admission and 1-3d after admission,tube feeding ,urinary catheters, had statistical significances between the two groups. Logistic regression analysis indicated dysphagia,the score of NIHSS(3d) were risk factors for SAI. (dysphagia :p=0.003,OR= 10.8, 95% confidence interval [2.222~52.504]; NIHSS (3d): p=0.015, OR=1.201, 95% confidence interval [1.036~1.391]).Conclusions: Multiple factors contribute to the occurrence of SAI, prevention and treatment in time should be emphasized to reduce the attacks of SAI. Objective: To observe the relationship between stroke-associated infection with stress response and cell immunity,so as to explore the impossible invasion mechanism of stroke-associated infection.Methods : In our prospective study, 85 patients were enrolled consecutively and admitted to hospital within 24h after symptoms onset. The patients with stroke were divided into infection (n=29) and non-infection (n=56) groups according to whether the infection occurred or not within one week after symptom onset. On day 1 and 7 after the admission,record NIHSS score and obtain the blood from all patients. Cortisol level,T lymphpcytes subsets,IFN-γ,IL-4,IL-10 levels were measured by radioimmunoanalysis, ELISA and fluid cell machine.Results: Compare with non-infection group, blood plasma serum cortisol and IL-4, IL-10 levels increased;the percentages of CD3+,CD4+ T cells and the level of plasma IFN-γreducced in infection group on day 1 and 7 after admission. The cortisol level has positive correlation of NIHSS score,plasma IL-4,IL-10 level;has negative correlat -ion of plasma IFN-γlevel and the percentages of CD3+,CD4+ T cells,CD4+/CD8 on day 1 after addmission. The cortisol level also has positive correlation of NIHSS score and negative correlation of the percentage of CD3+ T cells on day 7 after admission.Conclusion : The alteration of cortisol and the cell immunity have relationship with SAI, they may play important role of the occurrence of SAI.