老年多器官功能不全综合征临床特点分析

目的分析老年多器官功能障碍综合征（MODS）的患病特点。方法采用前瞻性的研究方法，收集2002年3月至2005年1月北京、天津、山东、河北、河南等地七所三级甲等医院545例MODS患者（老年373例，非老年172例）的临床资料，比较分析老年和非老年MODS患者的患病特点。结果老年组MODS患者的病死率、既往有慢性基础病的比例均显著高于非老年组（65．1％vs47．1％，81．5％vs41．9％，均P〈0．001）。老年组住ICU时间显著高于非老年组。老年组5个以上器官/系统功能障碍的发生率显著高于非老年组（78．6％ vs 70．3％，P=0．037）。老年组脑功能障碍的发生率明显高于非老年组（75．1％vs62．8％，P=0．003）。老年组发生肺、胃肠、脑、心、肝、肾、凝血系统功能障碍的病死率均显著高于非老年组。结论老年MODS患者病程迁延，病情重，病死率高，多合并慢性基础病，脑功能障碍的发生率高。

Clinical features of multiple organ dysfunction syndrome in the elderly: analysis of 545 cases

Objective To analyze the clinical features of multiple organ dysfunction syndrome in the elderly （MODSE）. Methods Clinical data of 545 cases of MODSE were collected and studied prospectively in 7 tertiary-level teaching hospitals of Beijing and Tianjin cities and Shandong, Hebei and Henan provinces from March 2002 to January 2005. They were divided into 2 groups： elderly group （172 cases） and non-elderly group （373 cases）, and their clinical data were compared and analyzed. Results The mortality in elderly group was obviously higher than that in non-elderly group （65.1% vs 47.1%, P〈0. 001）. Of the elderly patients, 81.5% had a history of chronic diseases, which was higher than that of non-elderly patients（41.9%, P〈0. 001）. The proportion of patients with more than 5 organs/systems dysfunction was higher in elderly group than in non elderly group （78.6% vs 70.3%, P=0. 037）. The incidence of brain dysfunction was higher in elderly group than in non-elderly group （75.1% vs 62.8%, P= 0. 003）. Besides, the fatality rate due to lung, brain, cardiovascular system, liver, kidney, gastrointestinal system and coagulation system dysfunction was higher in elderly group than in non-elderly group. Conclusion The elderly with MODS has long course of disease, serious clinical manifestations, high fatality rate and high incidence of brain dysfunction and most patients have chronic diseases.