190例SARS死亡相关因素的临床分析  

Possible Death-related Risk Factors of Severe Acute Respiratory Syndrome: A Clinical Analysis of 190 Death Patients

作　　者：王敬萍 朱莉贞 刘喆 郑素华 李素娟[2] 高宜秦[2] 赵荣国[3] 范渡[4] 李三军[4] 程尉新[5] 刘德恭[4] 高明哲[6] 

机构地区：[1]北京市结核病和胸部肿瘤研究所,北京101149 [2]北京市卫生局,北京100053 [3]中国医科院中国协和医科大学北京协和医院,北京100730 [4]北京佑安医院,北京100031 [5]解放军第304医院,北京100090 [6]北京市安贞医院,北京100029

出　　处：《中华医院感染学杂志》2004年第3期281-284,共4页Chinese Journal of Nosocomiology

摘　　要：目的　探讨严重急性呼吸综合征 (SARS)死亡患者可能的相关危险因素。方法　通过对北京市 SARS医疗救治指挥中心收到的按照卫生部颁发的 SARS诊断标准确诊的 190份死亡病历进行回顾性分析。结果　 190例死亡患者中年龄 >4 5岁占 75 .3% ;病变侵犯程度以双侧肺部改变为主 72 .9% ;合并有基础疾病占 75 .3% ,其发病至死亡时间 (11.2 5± 7.4 4 ) d;与无伴发基础疾病组 (16 .5 3± 9.12 ) d进行比较明显缩短 ,两者具有统计学意义 P <0 .0 0 1;有 14 0例患者 (73.7% )应用了甲泼尼龙治疗 ,且激素总量 >1.0 g出现并发症占 6 2 .8% ;有 31.8%继发了不同程度的感染 ;临床首发最常见的症状为发热 (10 0 % ) ;咳嗽 75 .3% ,以干咯多见 ;有 6 3.7%患者表现为低氧血症。结论　影响或导致 SARS死亡的危险因素是复杂的多方面的 ,可能与年龄、病变侵犯程度、是否伴有基础疾病、应用激素总量及继发感染等密切相关。OBJECTIVE To investigate the possible risk factors for death of the severe acute respiratory syndrome (SARS). METHODS One-hundred ninety patients who died of SARS referred to Beijing Municipal SARS Task Force were studied retrospectively. RESULTS 86.8% in 190 patients had confident epidemiology history. There were 105 male patients and 85 female patients. The average age of patients was (58.0±16.0) years. The days of onset of illness to death was (16.51±9.19) d. The common complaints were fever (100 percent); cough (75.3%). Chest X-ray revealed changes related to pneumonia, involving the majority area of the lung in 72.9% of the patients. 75.3% accompanied underlying disease, the days of onset of illness to death was (11.25±7.44) d, It was significantly shorter than without underlying diseases (P<0.001). 73.7% of patients adopted steroids treatment. There were 31.8% of patients causing infection in varying degree. 63.7% of patients was with hypoxemia. CONCLUSIONS The death-related risk factors of SARS were complicated and versatile. The possible factors were related with age, underlying disease, X-ray, secondary disease, corticosteroids dosage.

关 键 词：SARS 危险因素 分析 

分 类 号：R183.3[医药卫生—流行病学]