严重急性呼吸综合征死亡原因分析  

Possible Risk Factor for Death Patients with Severe Acute Respiratory Syndrome

作　　者：孟艳英[1] 王曙照[1] 张可[1] 黄春[1] 

机构地区：[1]首都医科大学附属北京佑安医院感染科

出　　处：《首都医科大学学报》2004年第3期335-337,共3页Journal of Capital Medical University

摘　　要：为分析导致SARS患者死亡的危险因素 ,对 2 0 0 3年 3月至 6月在佑安医院死亡的 1 5例SARS患者的死亡原因进行分析。结果 :1 5例患者年龄 2 3～ 81岁 ,平均 ( 5 0 .7± 1 8.8)岁 ,其中年龄大于 5 0岁的 7例。基础病 :合并糖尿病 5例 ,高血压病 5例 ,慢性肾功能不全、尿毒症期 2例。T细胞亚群 :病程第 1周CD4 + T淋巴细胞明显降低 ,平均CD4 + ( 2 48± 82 )个 /μL ,第 2和第 3周继续下降 ,分别为 ( 1 81± 1 2 8)个 /μL和 ( 1 2 5± 46)个 /μL ,与痊愈组患者比较差异具有显著性 (P <0 .0 5 )。胸部影像学变化 :1 5例中 7例患者胸部影像学显示均在 7d内进展到双肺广泛磨玻璃样变或实变。CK及CK MB :平均CK( 2 69.3± 3 99.9)U/L ,CK MB( 3 1 .1± 2 6.1 )U/L。提示 :SARS患者若伴有高龄、多合并症、T细胞亚群进行性下降、快速进展的双肺广泛实变、CK及CKMB升高等情况时 。The aim was to explore the possible risk factor for death patients with Severe Acute Respiratory Syndrome. 15 death SARS patients from March to June 2003 were analyzed. Results: Age: 23 to 81years old, average age were (50.7±18.8) years old, 7 patients were more than 50 years old. Underlying disease: 5 patients with diabetes, 5 patients with hypertension, 2 patients with chronic renal function failure and uraemia. T subset: CD 4 + T lymphocyte decreased significantly at the first week of disease period and average CD 4 +T count were (248±82)cells/μL, average CD 4 + T count were (181±128)cells/μL at second week and (125±46)cells/μL at third week, compared with group of cured patients, it had significantly difference(P<0.05). Chest image: chest image of 7 patients was apparent of pan-ground glass and consolidation in bilateral lung lobes. CK and CK-MB: average CK were ( 269.3± 399.9)U/L and CK-MB were (31.1±26.1)U/L. The adverse clinical outcome will be shown if SARS patient with older age, multi-underlying disease, rapid decrease in T subset, rapid progress of appearance of pan-consolidation in chest image, elevate of CK and CK-MB.

关 键 词：SARS患者 CK-MB 严重急性呼吸综合征 T细胞亚群 死亡原因分析 年龄 基础病 平均 极差 下降 

分 类 号：R563.1[医药卫生—呼吸系统] R542[医药卫生—内科学]