【摘要】 目的 评估初始总胆固醇（TC）对卒中相关性肺炎（SAP）患者抗生素疗程的预测价值。方法 选取2021年1月至2022年12月期间在邯郸市第一医院神经内科住院的SAP患者。收集患者的基线特征和实验室数据,包括入院时的TC、高密度脂蛋白（HDL）、低密度脂蛋白水平（LDL）。进行单变量和多变量分析,以确定TC水平与抗生素治疗时间的关系。结果 共纳入69例患者。抗生素疗程≤7d为短疗程组,共18例,占比26.1%;抗生素疗程>7d为长疗程组,共51例,占比73.9%。短疗程组TC水平高于长疗程组(平均值4.5mmol·L^-1±1.17 vs平均值3.6mmol·L^-1±0.93;P=0.002)。短疗程组HDL水平高于长疗程组(平均值1.28mmol.L^-1±0.35 vs平均值1.03mmol·L^-1±0.26;P=0.02)。使用Logistic回归模型进行多变量分析表明,TC与抗生素疗程延长呈负相关（OR:0.467;95%CI:0.257～0.849;P=0.013）;HDL与抗生素疗程延长呈负相关（OR:0.080;95%CI:0.007～0.942;P=0.045）。TC预测长疗程的ROC下面积（AUC）为0.721 （95%CI:0.582～0.860;P=0.006）,最佳截断值是4.Ommol.L-1,其灵敏度和特异度分别为0.765、0.722;HDL预测长疗程的ROC下面积（AUC）为0.704 （95%CI:0.554～0.853;P=0.011）,最佳截断值是1.30 mmol·L^-1,其灵敏度和特异度分别为0.784、0.556。结论 初始TC及HDL水平的降低与SAP患者抗生素治疗时间的增加有关。初始TC、HDL水平可能是预测SAP患者抗生素疗程延长的生物标志物。更多还原

【Abstract】 Objective This study evaluated the predictive value of initial total cholesterol（TC） for antibiotic course in stroke-related pneumonia（SAP） patients.Methods This study involving patients with SAP who were admitted to the Department of Neurology of Handan First Hospital from January 2021 to December 2022.Baseline characteristics and laboratory data were collected,including TC,high density lipoprotein（HDL）,and low density lipoprotein（LDL） levels at admission.Univariate and multivariate analyses were performed to determine the relationship between TC levels and the duration of antibiotic treatment.Results A total of 69 patients were included.The short course of antibiotic treatment≤7 days was 18 patients（26.1%）.Fifty-one patients（73.9%） were enrolled in the long course group（antibiotic course> 7 days）.TC level in the short course group was higher than that in the long course group(mean 4.5 mmol·L^-1±1.17 vs mean 3.6mmol·L^-1±0.93;P=0.002).The HDL level in the short course group was higher than that in the long course group(mean 1.28 mmol·L^-1 ±0.35 vs mean 1.03 mmol·L^-1±0.26;P=0.02).Multivariate analysis using Logistic regression model showed that TC was negatively correlated with antibiotic course extension（OR:0.467;95% Cl:0.257-0.849;P=0.013）;HDL was negatively correlated with prolonged antibiotic course（OR:0.080;95% Cl:0.007-0.942;P=0.045）.Area under ROC（AUC） for TC prediction of long treatment course was 0.721（95% Cl:0.582-0.860;P=0.006）,the best truncation value was 4.0 mmol·L-,,and the sensitivity and specificity were 0.765 and 0.722,respectively.The area under ROC（AUC） predicted by HDL for long course of treatment was 0.704（95% CI:0.554-0.853;P=0.011）,the best truncation value was 1.30 mmol·L^-1,and the sensitivity and specificity were 0.784 and 0.556,respectively.Conclusion The decrease of initial TC and HDL levels is related to the increase of antibiotic treatment time in SAP patients.Initial TC and HDL levels may be biomarkers for predicting prolonged antibiotic course in SAP patients.更多还原