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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 related to the death of severe acute respiratory syndrome (SARS). Methods A retrospective analysis of 190 death records confirmed by the SARS Medical Treatment Command Center in Beijing according to the SARS diagnostic criteria issued by the Ministry of Health was conducted. Results Of the 190 deaths, 75.3% were older than 45 years old. The extent of the lesion was 72.9% with bilateral lung changes and 75.3% with underlying diseases. The morbidity to the time of death (11.2 5 ± 7.4 4) d. Compared with uncontrolled group (16.53 ± 9.12) d, the difference was statistically significant (P <0.01). There were 140 cases (73.7% ) Had methylprednisolone treatment, and the total amount of hormones> 1.0 g showed complications (62.8%); 31.8% of them had different degrees of secondary infection; the most common clinical symptom was fever (100%); Cough 75.3%, more common in dry; there are 6 3.7% of patients showed hypoxemia. Conclusion The risk factors affecting or causing SARS death are complex and multifaceted, and may be closely related to age, extent of disease invasion, underlying diseases, total hormone application and secondary infection.