重症SARS患者转归因素的分析——附165例报告  

Study on prognostic factors of severe acute respiratory syndrome: An analysis of 165 cases

作　　者：常彬霞[1] 常伟华[1] 刘艳平 马雪梅[1] 荣义辉[1] 邹正升[1] 周先志[1] 胡良平[2] 杨永平[1] 陈菊梅[1] 

机构地区：[1]解放军第302医院,北京100039 [2]军事医学科学院情报所,北京100071

出　　处：《第二军医大学学报》2003年第8期817-820,共4页Academic Journal of Second Military Medical University

基　　金："十五"863计划重大项目 ( 2 0 0 3 AA2 0 810 6)

摘　　要：目的 :分析影响严重急性呼吸综合征 (SARS)患者预后的诸因素 ,以指导临床救治及疗效判定。 方法 :采用 SPSS11.0及 SDAS软件回顾性分析 16 5例临床确诊的重症 SARS患者的临床特征 ,确定影响 SARS转归的诸因素。 结果 :(1)年龄与预后显著相关 (r=0 .5 0 6 ,P<0 .0 0 1) ,≤ 5 0岁与 >5 0岁患者的病死率分别为 4 .0 8%及 5 3.3% (P<0 .0 1) ;(2 )有无基础病变与预后显著相关 (r=0 .4 5 7,P<0 .0 0 1) ,其病死率分别为 5 4 .5 %及 7.5 % (P<0 .0 1) ;(3)入院时 CK、L DH、CK- MB、AST、HBDH、尿素改变、肌酐改变与预后相关 ,Pearson相关系数分别为 0 .5 2 0、0 .4 97、0 .4 85、0 .4 71、0 .35 8、0 .371及 0 .339(P均 <0 .0 1) ;(4 )病情最重时淋巴细胞绝对数 (L y)、Plt计数、尿常规改变、L DH、HBDH、CK- MB、AST、尿素、CK、TB、尿素改变、肌酐改变、呼吸频率、低氧血症程度、胸片受累肺叶数与预后相关 ,Pearson相关系数分别为 - 0 .2 5 7、- 0 .4 73、0 .5 4 4、0 .788、0 .6 96、0 .5 86、0 .4 81、0 .379、0 .36 8、0 .32 9、0 .2 79、0 .4 14、0 .72 8、0 .76 5及 0 .36 6 (P均 <0 .0 5 )。 结论 :重症 SARS患者转归与年龄 ,病前基础病变 ,病情最重时的 L y、Plt、尿常规改变、呼吸频率、低氧血症?Objective:To analyze the factors affecting the prognosis of severe acute respiratory syndrome(SARS) to better guide clinical treatment and judge the curative effects.Methods:SPSS 11.0 and SDAS software packages were used to retrospectively analyze the clinical features of SARS in 165 clinically confirmed severe SARS cases. The single factor analyses were conducted for SARS prognosis.Results:(1)The age was significantly correlated to the prognosis of SARS patients ( r = 0.506, P <0.001). The mortality was 4.08% and 53.3% in patients ≤50 years old and those >50 years old,respectively ( P <0.01). (2) The existence of other diseases before SARS was significantly correlated to the prognosis of SARS patients ( r = 0.457, P <0.001). The mortality was significantly higher in patients with other diseases before SARS than in those without (54.5% vs 7.5%, P <0.01). (3)The CK,LDH,CK MB,AST,HBDH level on admission were markedly correlated to the prognosis( r =0.520,0.497,0.485,0.471,0.358,0.371,0.339, P <0.05); (4) During the advanced stage of SARS,the absolute number of lymphocytes(Ly),Plt,routine urine parameters changes,LDH,HBDH,CK MB,AST,urea,CK,TB,urea and Cr changes,respiratory rate,degree of hypoxemia and number of involved pulmonary lobes were all markedly correlated to the prognosis of SARS( r =-0.257,-0.473,0.544,0.788,0.696,0.586,0.481,0.379,0.368,0.329,0.279,0.414,0.728, 0.765, 0.366, P <0.05). Conclusion: The age,the existence of other diseases before SARS,Ly,PLT,routine urine parameters changes,respiratory rate,degree of hypoxemia and number of involved pulmonary lobes,TB,urea are all markedly correlated to the prognosis of SARS during the advanced stage. AST,LDH,CK,CK MB,HBDH,urea and Cr changes are markedly correlated to the prognosis on admission and during the advanced stage of SARS.

关 键 词：严重急性呼吸综合征 多因素分析 预后 救治 疗效 

分 类 号：R563.1[医药卫生—呼吸系统]