新型甲型H1N1流感92例死亡高危因素分析  

High risk factors of death in 92 patients with novel influenza A.

作　　者：李杰[1] 代冰[1] 赵洪文[1] 康健[1] 

机构地区：[1]中国医科大学附属第一医院呼吸科,沈阳110001

出　　处：《中国实用内科杂志》2011年第3期213-215,共3页Chinese Journal of Practical Internal Medicine

基　　金：辽宁省医学高峰建设工程重点科研项目(200922)

摘　　要：目的分析新型甲型H1N1流感患者死亡的高危因素。方法回顾性分析中国医科大学附属第一医院呼吸科2009—10—24—2010—01—15收治的92例新型甲型H1N1流感患者病程早期的临床资料，比较死亡组和存活组之间临床特征，经多变量Logistic回归分析确定患者死亡的高危因素。结果单因素分析中，早期呼吸困难、咯血痰、肌酸激酶同工酶和乳酸脱氢酶升高、低钙血症、T细胞亚群降低、D-二聚体升高、肺损伤程度和氧合指数降低、ASOFA评分、APACHⅡ评分等因素在死亡组和存活组之间差异有统计学意义；经多变量Logistic回归分析，继发感染（OR=1．563，95％CI：1．213～1．682）、APACHⅡ评分（OR=1．217，95％CI：1．052～1．435）和ASOFA评分（OR=1．136，95％CI：1．024～1．213）是患者死亡的独立危险因素。结论临床上应重视并针对上述危险因素制订相应的防治措施，以期降低病死率。Objective To explore the high risk factors of death in patients with novel influenza A （H1N1 ）. Methods We retrospectively analyzed the early clinical data from 92 patients （including t 2 deaths） with novel influenza A （ H1N1 ） , and compared the clinical features between the dead and the survival groups. Multivariate Logistic regression analysis was used for analyzing the high risk factors of death. Results According to univariate analysis, statistical differences between dead and survival group were found in early-onset dyspnea, bloody sputum, increased CK-MB and LDH, hypocalcemia, reduced T cell subsets, increased D-dimer levels, lung injury, de- creased oxygenation index, ASOFA and APACH lI scores. The muhivariable Logistic regression analysis showed that secondary infection （ OR = 1. 563,95% CI： 1. 213 - 1. 682 ）, APACHE I] score （ OR = 1. 217,95% CI ： 1. 052 - 1. 435 ） and ASOFA score （ OR = 1. 136,95% CI ： 1. 024 -1. 213 ） were the independent risk factors for death from novel influenza A （ H1N1 ）. Conclusion These risk factors should prompt alerts, and preventive measures against these risk factors should be instituted in clinical practices so as to reduce mortality.

关 键 词：新型甲型H1N1流感 

分 类 号：R5[医药卫生—内科学]