中国妇幼保健

目的 分析非吸烟女性发生脑卒中和肺部感染并发症风险的影响因素。方法 选取2022年1月—2025年1月在台州市第一人民医院进行治疗的非吸烟脑卒中女性患者88例作为卒中组，另选取同期在该院体检未发生脑卒中的40例非吸烟女性作为非卒中组。收集卒中组和非卒中组一般资料，包括年龄、体质指数、婚姻状况、文化程度、基础疾病、脑血管病家族史、既往卒中史、过量饮酒、规律运动、久坐及饮食均衡，采用多因素logistic回归分析筛选影响非吸烟女性脑卒中的影响因素。按照是否合并肺部感染并发症将88例非吸烟脑卒中女性患者分为合并组(18例)和未合并组(70例),比较合并组和未合并组一般资料，包括年龄、体质指数、卒中类型、肺部基础疾病史、脑血管病家族史、既往卒中史、意识障碍、鼻饲、气管插管及口腔功能障碍，并比较合并组和未合并组实验室相关指标，包括降钙素原(PCT)、血清C-反应蛋白(CRP)、血浆白蛋白、血小板计数及白细胞计数(WBC),采用多因素logistic回归分析筛选影响非吸烟脑卒中女性肺部感染的影响因素。结果 卒中组和非卒中组患者年龄、体质指数、糖尿病、过量饮酒、规律运动、久坐及饮食均衡情况比较，差异均有统计学意义(均P<0.05);多因素logistic回归分析结果显示，年龄(OR=5.393)、过量饮酒(OR=2.666)、规律运动(OR=0.309)及久坐(OR=3.349)均是非吸烟女性脑卒中的独立影响因素(均P<0.05)。合并组患者与未合并组患者年龄、体质指数、卒中类型、肺部基础疾病史、脑血管病家族史、意识障碍、鼻饲、气管插管、口腔功能障碍、PCT、CRP及血浆白蛋白情况比较，差异均有统计学意义(均P<0.05);多因素logistic回归分析结果显示，脑出血(OR=3.830)、肺部基础疾病史(OR=4.096)、气管插管(OR=4.778)、PCT(OR=2.682)、CRP(OR=3.018)及血浆白蛋白(OR=0.238)均是非吸烟女性脑卒中的独立影响因素(均P<0.05)。结论 年龄、过量饮酒、规律运动及久坐均是非吸烟女性脑卒中的独立影响因素，脑出血、肺部基础疾病史、气管插管、PCT、CRP及血浆白蛋白均是非吸烟脑卒中女性肺部感染的独立影响因素。

Objective To analyze the factors influencing the risk of stroke and pulmonary infection complications in non-smoking women. Methods A total of 88 non-smoking female patients with stroke who were treated at Taizhou First People's Hospital from January 2022 to January 2025 were selected as the stroke group, and 40 non-smoking women who underwent physical examinations at the same hospital during the same period without stroke were selected as the non-stroke group. General data of the stroke group and non-stroke group were collected, including age, body mass index, marital status, education level, underlying diseases, family history of cerebrovascular disease, previous stroke history, excessive alcohol consumption, regular exercise, sedentary behavior, and balanced diet. Multivariate logistic regression analysis was used to identify factors influencing stroke in non-smoking women. The 88 non-smoking female stroke patients were further divided into a combined group(18 cases) and a non-combined group(70 cases) based on the presence of pulmonary infection complications. General data of the combined and non-combined groups were compared, including age, body mass index, stroke type, history of underlying pulmonary diseases, family history of cerebrovascular disease, previous stroke history, disturbance of consciousness, nasal feeding, tracheal intubation, and oral dysfunction. Laboratory-related indicators, including procalcitonin(PCT), serum C-reactive protein(CRP), plasma albumin, platelet count, and white blood cell(WBC) count, were also compared between the two groups. Multivariate logistic regression analysis was used to identify factors influencing pulmonary infection in non-smoking female stroke patients.Results Statistically significant differences were observed between the stroke group and the non-stroke group in terms of age, body mass index, diabetes, excessive alcohol consumption, regular exercise, sedentary behavior, and balanced diet(all P<0.05). Multivariate logistic regression analysis showed that age(OR=5.393), excessive alcohol consumption(OR=2.666), regular exercise(OR=0.309), and sedentary behavior(OR=3.349) were independent influencing factors for stroke in non-smoking women(all P<0.05). Statistically significant differences were observed between the combined group and the non-combined group in terms of age, body mass index, stroke type, history of underlying pulmonary diseases, family history of cerebrovascular disease, disturbance of consciousness, nasal feeding, tracheal intubation, oral dysfunction, PCT, CRP, and plasma albumin(all P<0.05). Multivariate logistic regression analysis showed that cerebral hemorrhage(OR=3.830), history of underlying pulmonary diseases(OR=4.096), tracheal intubation(OR=4.778), PCT(OR=2.682), CRP(OR=3.018), and plasma albumin(OR=0.238) were independent influencing factors for pulmonary infection in non-smoking female stroke patients(all P<0.05). Conclusion Age, excessive alcohol consumption, regular exercise, and sedentary behavior are independent influencing factors for stroke in non-smoking women. Cerebral hemorrhage, history of underlying pulmonary diseases, tracheal intubation, PCT, CRP, and plasma albumin are independent influencing factors for pulmonary infection in non-smoking female stroke patients.