Immunodepression As a Risk Factor of Infection in Patients with Acute Ischemic Stroke

Ken Wirastuti
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Abstract

Background: Immunodepression is an absence or deficient supply of the components of either humoral or cellular immunity, or both. Previous studies show that the central nervous system and the immune system interact in complex ways. Better insight into these interactions may be relevant to the treatment of patients with stroke and other forms of central nervous system injury. This study aimed to determine immunodepression as a risk factor of infection in patients with acute ischemic stroke. Subjects and Method: This was a cohort study conducted in Sultan Agung Islamic Hospital, Semarang, Central Java. A sample of 89 patients with post-acute ischemic stroke who had been hospitalized for ≥5 days was selected for this study as the exposed group and nonstroke patients as non-exposed group. The dependent variable was immunodepression infection as indicated by high leucocytes, high neutrophils, low lymphocytes, low monocytes. The independent variable was post-acute ischemic stroke. The data were obtained from the medical record. The data were analyzed by a chi-square test with Risk Ratio (RR) as the measure of association. Results: Post-acute ischemic stroke was associated with an increased risk of leucocytosis (RR= 3.95%; 95% CI= 1.59 to 3.27), neutrophilia (RR= 1.98; 95% CI= 1.69 to 12.63), lymphocytopenia (RR= 1.77; 95% CI= 1.51 to 1.98), monocytopenia (RR= 1.85%; 95% CI= 1.33 to 1.92). Conclusion: Acute ischemic stroke increases the risk of infection due to immunodepression. Keywords: acute ischemic stroke, immunodepression, infection
免疫抑制是急性缺血性脑卒中患者感染的危险因素
背景:免疫抑制是体液免疫或细胞免疫成分的缺乏或不足,或两者兼而有之。先前的研究表明,中枢神经系统和免疫系统以复杂的方式相互作用。更好地了解这些相互作用可能与中风和其他形式中枢神经系统损伤患者的治疗有关。本研究旨在确定免疫抑制是急性缺血性脑卒中患者感染的危险因素。对象和方法:这是一项在中爪哇三宝垄苏丹阿贡伊斯兰医院进行的队列研究。本研究选取住院≥5天的急性缺血性卒中后患者89例为暴露组,非卒中患者为非暴露组。因变量为免疫抑制感染,表现为白细胞高、中性粒细胞高、淋巴细胞低、单核细胞低。自变量为急性缺血性脑卒中后。数据是从医疗记录中获得的。数据采用卡方检验,以风险比(RR)作为相关性的衡量标准。结果:急性缺血性卒中后与白细胞增多的风险增加相关(RR= 3.95%;95% CI= 1.59 ~ 3.27),中性粒细胞(RR= 1.98;95% CI= 1.69 ~ 12.63),淋巴细胞减少症(RR= 1.77;95% CI= 1.51 ~ 1.98),单核细胞减少症(RR= 1.85%;95% CI= 1.33 ~ 1.92)。结论:急性缺血性脑卒中患者因免疫抑制而增加感染风险。关键词:急性缺血性脑卒中,免疫抑制,感染
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