Cerebral infarction in the left hemisphere compared with the right hemisphere increases the risk of aspiration pneumonia.
Cerebral infarction in the left hemisphere compared with the right hemisphere increases the risk of aspiration pneumonia.
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发表时间：
2014-12
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通讯作者：
Keiichi Yamamoto;Hideo Koh;H. Shimada;J. Takeuchi;Y. Yamakawa;M. Kawamura;T. Miki
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作者：
Keiichi Yamamoto;Hideo Koh;H. Shimada;J. Takeuchi;Y. Yamakawa;M. Kawamura;T. Miki
背景吸入性肺炎是脑梗死最严重的并发症之一。然而，没有关于CI的类型或位置与AP发病率之间关系的报道。此外，从未研究过导致误吸的吞咽困难与CI类型或位置之间的关系。因此，我们假设CI的偏侧性影响吞咽困难和AP的发展。方法：我们进行了一项回顾性队列研究，在133例患者中检查CI偏侧性与吞咽困难和AP发生率之间的关系。结果左侧脑梗死组AP发生率为6.0%，右侧脑梗死组AP发生率为0.8%。单变量logistic回归分析显示，左侧CI是AP的显著预测因子（风险比，8.81; 95%置信区间，1.07-72.59; p = 0.043）。即使在调整了年龄、性别、CI类型或糖尿病的存在后，左侧CI仍是AP的显著预测因子。此外，虽然吞咽困难作为AP的直接原因的频率根据偏侧性没有差异，但左侧CI组中吞咽困难引起的AP频率大于右侧CI组中观察到的频率。结论：左侧运动皮质至内囊脑梗死合并吞咽困难组发生AP的危险性高。
BACKGROUND Aspiration pneumonia (AP) following cerebral infarction (CI) has been considered as one of its most serious complications. Nevertheless, there are no reports on the association between the type or location of CI and the incidence of AP. In addition, the association between dysphagia, which leads to aspiration, and the type or location of CI has never been investigated. Therefore we hypothesized that the laterality of CI affects the development of both dysphagia and AP. METHODS We performed a retrospective cohort study to examine the association between the laterality of CI and the incidence of dysphagia and AP in 133 patients. RESULTS AP was found in 6.0% of the group with left CI and in 0.8% of the group with right CI. A univariate logistic regression analysis revealed that left CI was a significant predictor of AP (hazard ratio, 8.81; 95% confidence interval, 1.07-72.59; p = 0.043). Left CI was a significant predictor of AP even after adjusting for age, sex, CI type, or presence of diabetes mellitus. In addition, although the frequency of dysphagia as the direct cause of AP did not differ according to laterality, the frequency of AP that ensued from dysphagia in the left CI group was greater than that observed in the right CI group. CONCLUSIONS The group with left CI from the motor cortex to the internal capsule complicated by dysphagia exhibited a high risk of AP.