中文摘要：

目的对脑卒中伴感染患者的临床数据进行分析,了解脑卒中发生后感染性疾病的发展规律。方法收集四川大学华西医院脑卒中伴感染患者临床资料,根据脑卒中临床分类,将患者分为缺血性脑卒中组和出血性脑卒中组,出血性脑卒中组又分为颅内出血组和蛛网膜下腔出血组。统计资料包括人口学信息,感染类型,病原菌特点和耐药特点等。结果 572例脑卒中患者,男性55.94%,女性44.06%。缺血性脑卒中组（288例）发病年龄以61～90岁为主（77.08%）;出血性脑卒中组（284例）发病年龄以31～60岁为主（52.11%）。两组患者尿路感染率分别为61%、28.19%,血流感染率分别为18.6%、29.38%。蛛网膜下腔出血组（147例）尿路感染率（33.5%）显著高于颅内出血组（137例,22.6%,P〈0.05）。从655份标本中分离到病原菌809株,其中大肠埃希菌20.89%,鲍曼不动杆菌9.27%,肺炎克雷伯菌9.15%。标本分布为尿液44.12%,血液24.12%,分泌物12.52%等。出血性脑卒中组中肠杆菌科细菌对亚胺培南耐药率显著高于缺血性脑卒中组（P〈0.05）,而缺血性脑卒中组对氨基糖苷类抗生素和喹喏酮类抗生素的耐药率较出血性脑卒中组高（P〈0.05）。出血性脑卒中组非发酵菌对头孢菌素类抗生素的耐药率显著高于缺血性脑卒中组（P〈0.05）,但葡萄球菌属细菌耐药率显著低于缺血性脑卒中组（P〈0.05）。结论缺血性脑卒中患者伴发的感染类型主要以尿路感染和血流感染为主,出血性脑卒中患者血流感染风险显著增加。脑卒中不同临床类型患者病原菌以常见革兰阴性杆菌为主,院内感染发生的风险因素有增加倾向。各组患者病原菌耐药率不同,为合理使用抗生素提供了临床流行病学资料。

英文摘要：

Objective To assess clinical data of stroke patients accompanied with infection and to understand the development regulation of infectious complications following cerebral apoplexy. Methods The clinical data of stroke patients accompanied with infection from West China Hospital of Sichuan University were collected. Based on the clinical classification of cerebral apoplexy,patients were divided into the ischemic cerebral apoplexy and the hemorrhagic cerebral apoplexy group,and the latter were also divided into intracranial hemorrhage and subarachnoid hemorrhage group. Statistical data included demographic information,infection types,pathogen and drug-resistance characteristics. Results There were572 cases of cerebral apoplexy patients were in the present study,male accounting for 55. 94% and female occupying44. 06%. The onset of ischemic cerebral apoplexy group（ 288 cases） was primarily from 61 to 90 years old（ 77. 08%）;Hemorrhagic cerebral apoplexy group（ 284 cases） age was mainly from 31 ~ 60 years old（ 52. 11%）. Two groups of patients with urinary tract infection rates were 61%,28. 19%,bloodstream infection rates were 18. 6%,29. 38%. Urinary tract infection in subarachnoid hemorrhage group（ 147 cases,33. 5%）） was significantly higher than that in intracranial hemorrhage group（ 137 cases,22. 6%）（ P〈0. 05）. The pathogenic bacteria isolated from 655 specimens of 809 strains,e E. coli 20. 89%,9. 27% acinetobacter baumannii,klebsiellapneumoniae was 9. 15%. The specimen were urine（ 44. 12%）,blood（ 24. 12%）,secretions（ 12. 52%）. Imipenem-resistance of Enterobacteriaceae bacteria and Cephalosporin-resistance of the fermentation bacteria in hemorrhagic stroke group had a significantly higher percentages than those in ischemic cerebral apoplexy group（ P both 0. 05）,however,drug-resistant rates of the Aminoglycoside antibiotics and quinolones were relatively higher in ischemic stroke group（ P〈0. 05）,and the staphylococcus bacteria resistant rate was also significantly