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目的探讨急性重症脑卒中患者非感染性发热的危险因素。方法对2012年1月至2014年10月住院的急性重症脑卒中患者进行回顾性分析。对非感染性发热患者的危险因素首先进行单因素分析,然后进行多因素logistic回归分析,确定高危因素。结果单因素分析结果表明,意识障碍、脑干卒中、蛛网膜下腔出血、入院72h内发热、脑中线偏移、发病时血糖、发病时白细胞综述、应激性溃疡的患者非感染性发热的发生率高(P<0.05);而发病时血浆白蛋白水平低于正常、有吞咽障碍的患者感染性发热的发生率高。多因素logistic回归分析结果表明,SAH、72h内发热、脑中线偏移与非感染性发热高度关联。结论在急性重症脑卒中患者中非感染性发热的发生率较高,尤其是在蛛网膜下腔出血和脑中线移位的患者中。卒中后72h内发生的发热多数是非感染性发热。
Objective To explore the risk factors of noninfectious fever in patients with acute severe stroke. Methods A retrospective analysis was performed on patients with acute severe stroke hospitalized from January 2012 to October 2014. Risk factors for non-infectious fever were first univariate analysis, and then multivariate logistic regression analysis to identify risk factors. Results of univariate analysis showed that consciousness disturbance, brainstem stroke, subarachnoid hemorrhage, fever within 72h after admission, midline deviation, blood glucose at onset, incidence of leukocytes, stress ulcer in patients with non-infectious fever (P <0.05). However, the incidence of infectious albumin was lower than normal at onset, and the incidence of infectious fever was higher in patients with dysphagia. Multivariate logistic regression analysis showed that within 72h SAH, midline deviation was highly correlated with noninfectious fever. Conclusion The incidence of non-infectious fever is high in patients with acute severe stroke, especially in patients with subarachnoid hemorrhage and midline shift. The majority of fever that occurs within 72 hours of stroke is non-infectious fever.