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目的 评估Glasgow昏迷量表(GCS)评分对急性脑卒中后并发肺炎的预测作用.方法 采用回顾性研究方法,选择2010年1月至2014年12月在本院神经科住院治疗的急性脑卒中患者,根据入院后是否并发肺炎分为肺炎组(186例)和对照组(246例).比较两组患者临床特征差异性,分析急性脑卒中性肺炎危险因素,建立△GCS=15-GCS数学模型,评估GCS评分对卒中性肺炎的预测价值.结果 肺炎组年龄大、住院天数长、胃管进食、吞咽困难、意识障碍、头晕、房颤的比率高于对照组,差异有统计学意义(P<0.05);实验指标中血白细胞、中性粒细胞百分比、血糖、红细胞沉降率、国际标准化比率、活化部分凝血活酶时间、空腹血糖、ALT、AST、TBIL高于对照组,红细胞计数、血红蛋白低于对照组,差异有统计学意义(P<0.05).多因素Logistic回归分析结果显示:年龄、WBC、△GCS、入院胃管进食、吞咽困难是急性卒中性肺炎的危险因素.ROC曲线分析结果显示:△GCS评分预测急性卒中性肺炎的C值(C-statistic)为0.858(95％CI:0.821～0.896),差异有统计学意义(P<0.05).结论 △GCS能有效预测急性脑卒中并发肺炎的危险性,GCS评分越大,患卒中性肺炎的风险越小.“,”Objective To evaluate the predictive effect of Glasgow coma rating scale (GCS) score on acute stroke associated pneumonia patients. Methods 186 stroke associated pneumonia(SAP)patients that continuity hospitalized from January 2010 to December 2014 in the Neurology Department of our hospital were selected as pneumonia group ,and 246 patients of non-pneumonia after stroke were randomly chosen as control group for the retrospective study. The clinical characteristics and related factors of acute stroke associated pneumonia of the patients were compared. And then , mathematics model of △GCS=15-GCS was established to evaluate the predictive effect of GCS score for acute stroke associated pneumonia. Results There was statistically significant difference between the two groups of the levels of age , hospital stays,gastric tube feeding,dysphagia,atrial fibrillation,disturbance of consciousness,dizzy giddy,healed, improved and the levels of WBC,neutrophilic granulocyte percentage,RBC,Hb,Glucose,ESR,INR,APTT,Fbg, ALT,AST,TBIL(P<0.05). Multiple-factor analysis showed that the levels of age,WBC,△GCS,gastric tube feeding, dysphagia were the risk factors of acute stroke associated pneumonia. The result of Receiver operating characteristic curve showed that predictive C-statistic of △GCS score for acute stroke associated pneumonia was 0.858(95％CI:0.821～0.896), which had remarkable statistics meaning (P<0.001). Conclusion △GCS score provided an effective method for prediction of the risk of acute stroke associated pneumonia;the greater of GCS score ,the less risk of SAP.