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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

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【作者】 王敬萍朱莉贞刘喆郑素华李素娟高宜秦赵荣国范渡李三军程尉新刘德恭高明哲

【Author】 WANG Jing-ping1, ZHU Li-zhen1, LIU Zhe1, ZHENG Su-hua1, LI Su-juan2, GAO Yi-qing2, ZHAO Rong-guo3, FAN Du4, LI San-jun4, CHENG Wei-xin5, LIU De-gong4, GAO Ming-ze6 (1. Beijing Thoracic Tumor and Tuberculosis Institute, Beijing 101149, China; 2. Beijing Municipal Health Bureau, Beijing 100053, China; 3. Peking Union Medical College Hospital, Beijing 100730, China; 4. Beijing Youan Hospital, Beijing 100031, China; 5. The 304th Hospital of PLA, Beijing 100090, China; 6. Beijing Anzhen Hospital, Beijing 100029, China)

【机构】 北京市结核病和胸部肿瘤研究所北京市卫生局中国医科院中国协和医科大学北京协和医院北京佑安医院解放军第304医院北京市安贞医院 北京101149北京101149北京100053北京100730北京100031北京100090北京100029

【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。

【Abstract】 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.

  • 【文献出处】 中华医院感染学杂志 ,Chinese Journal of Nosoconmiology , 编辑部邮箱 ,2004年03期
  • 【分类号】R511.9
  • 【被引频次】4
  • 【下载频次】80
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