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目的:探讨急性脑梗死合并肺部感染病原菌特点及影响因素。方法:选择浙江衢化医院2016年1月至2019年12月收治的急性脑梗死120例为观察对象，根据是否合并肺部感染分为观察组（存在肺部感染）60例与对照组（无肺部感染）60例。采集急性脑梗死合并肺部感染患者痰液标本，分离病原菌；采用多因素logistic回归分析影响肺部感染独立危险因素。结果:急性脑梗死合并肺部感染患者60例中，分离病原菌64株，以革兰阴性菌为主，占64.06%（41/64）。经单因素分析，两组性别、吸烟史和吞咽功能障碍差异均无统计学意义（χn 2=0.564、0.315、2.172，均n P>0.05）；研究组年龄>60岁（67.19%）高于对照组（32.81%），合并基础疾病（69.23%）高于对照组（30.77%），既往肺部疾病（65.63%）高于对照组（34.37%），大面积梗死（69.57%）高于对照组（30.43%），侵入性治疗（73.08%）高于对照组（26.92%），昏迷（72.00%）高于对照组（28.00%），差异均有统计学意义（χn 2=16.205、8.547、4.261、24.859、7.070、6.114，均n P60岁、合并基础疾病、既往肺部疾病史、大面积梗死、侵入性治疗和昏迷为影响肺部感染独立危险因素（n OR=4.192、2.686、1.974、5.685、3.401、4.895，均n P 0.05). In the study group, the proportions of patients aged > 60 years (67.19% n vs. 32.81%, χn 2 = 16.205, n P < 0.05), patients with complicated basic disease (69.23% n vs. 30.77%, χn 2 = 8.547, n P < 0.05), patients with a previous history of lung disease (65.63% n vs. 34.37%, χn 2 = 4.261, n P < 0.05), patients with large area cerebral infarction (69.57% n vs. 30.43%, χn 2 = 24.859, n P < 0.05), patients with invasive treatment (73.08% n vs. 26.92%, χn 2 = 7.070,n P < 0.05) and patients with coma (72.00% n vs. 28.00%, χn 2 = 6.114,n P 60 years old, complicated basic disease, previous lung disease, large area infarction, invasive treatment and coma were the independent risk factors of pulmonary infection ( n OR = 4.192, 2.686, 1.974, 5.685, 3.401, 4.895,all n P < 0.05).n Conclusion:Gram negative bacteria are the main pathogens isolated from patients with acute cerebral infarction complicated by pulmonary infection. Age, basic disease, a previous history of lung disease, infarct area, invasive treatment and coma are independent risk factors of pulmonary infection.