严重急性呼吸综合征死亡原因分析

为分析导致SARS患者死亡的危险因素 ,对 2 0 0 3年 3月至 6月在佑安医院死亡的 1 5例SARS患者的死亡原因进行分析。结果 :1 5例患者年龄 2 3～ 81岁 ,平均 ( 5 0 .7± 1 8.8)岁 ,其中年龄大于 5 0岁的 7例。基础病 :合并糖尿病 5例 ,高血压病 5例 ,慢性肾功能不全、尿毒症期 2例。T细胞亚群 :病程第 1周CD4 + T淋巴细胞明显降低 ,平均CD4 + ( 2 48± 82 )个 /μL ,第 2和第 3周继续下降 ,分别为 ( 1 81± 1 2 8)个 /μL和 ( 1 2 5± 46)个 /μL ,与痊愈组患者比较差异具有显著性 (P <0 .0 5 )。胸部影像学变化 :1 5例中 7例患者胸部影像学显示均在 7d内进展到双肺广泛磨玻璃样变或实变。CK及CK MB :平均CK( 2 69.3± 3 99.9)U/L ,CK MB( 3 1 .1± 2 6.1 )U/L。提示 :SARS患者若伴有高龄、多合并症、T细胞亚群进行性下降、快速进展的双肺广泛实变、CK及CKMB升高等情况时 ,预后极差

Possible Risk Factor for Death Patients with Severe Acute Respiratory Syndrome

The aim was to explore the possible risk factor for death patients with Severe Acute Respiratory Syndrome.15 death SARS patients from March to June 2003 were analyzed.Results: Age: 23 to 81years old, average age were (50.7±18.8) years old, 7 patients were more than 50 years old.Underlying disease: 5 patients with diabetes, 5 patients with hypertension, 2 patients with chronic renal function failure and uraemia.T subset: CD⁴⁺ T lymphocyte decreased significantly at the first week of disease period and average CD⁴⁺T count were (248±82)cells/μL, average CD⁴⁺ T count were (181±128)cells/μL at second week and (125±46)cells/μL at third week, compared with group of cured patients, it had significantly difference(P<0.05).Chest image: chest image of 7 patients was apparent of pan-ground glass and consolidation in bilateral lung lobes.CK and CK-MB: average CK were ( 269.3± 399.9)U/L and CK-MB were (31.1±26.1)U/L.The adverse clinical outcome will be shown if SARS patient with older age, multi-underlying disease, rapid decrease in T subset, rapid progress of appearance of pan-consolidation in chest image, elevate of CK and CK-MB.