严重急性呼吸道综合征死亡危险因素分析

目的　分析山西地区 2 4例严重急性呼吸道综合征 (SARS)死亡病例临床特征及导致死亡危险因素。方法　对 2 0 0 3年 3月 7日至 6月 4日山西地区 2 4例 SARS死亡病例的临床资料进行回顾性分析。结果　 2 4例患者男 13例 (5 5 % ) ,女 11例 (4 6 % ) ;主要临床表现为发热、咳嗽、畏寒、气促等。发病早期的白细胞总数 ,淋巴细胞总数下降。胸部 X线显示肺部斑片状阴影 ,短期内病灶增多 ;7d内死亡 3例 (12 % ) ,7～ 14 d死亡 11例(4 7% ) ,14 d以上死亡 10例 (4 4 % ) ;14例 (5 0 % )病人有基础疾病 ,其中 4例 (16 % )糖尿病 ,4例 (16 % )脑血管病 ,3例 (12 % )心血管病 ,6例 (2 5 % )高血压 ,其中 7例 (2 9% )同时合并 2种以上疾病 ;2 4例中直接死于 SARS19例(79% ) ,死于基础疾病 5例 (2 1% ) ;多因素分析结果显示 :年龄 >5 0岁、有无心理治疗、早期淋巴细胞计数为影响死亡危险因素。结论　年龄 >5 0岁、早期淋巴细胞计数降低是该病死亡危险因素 ;心理治疗是保护因素

Risk factor analysis for death of severe acute respiratory syndrome

Objective To analyze clinical features and risk factors for death of 24 cases of SARS in Shanxi province.Methods Clinical materials of 24 dead cases of SARS from March 7 to June 4,2003 in Shanxi were retrospectively analyzed.Results There were 13 (55%) male patients and 11 (46%) female patients,the main clinical features were fever,coughing,and dyspnea,etc.The amounts of WBC and lymphocyte obviously decreased.Chest X-ray examination revealed the changes related to pneumonia.Three cases (12%) died within seven days,eleven cases (47%) died within seven to fourteen days,and ten died after two weeks.Fourteen patients (50%) had basal diseases,of them 4 (16%) had diabetes,4 (16%) had cerebrovascular disease,3 (12%) had cardiovascular disease,and 6 (25%) with hypertension.There were 7 (29%) patients with more than two diseases.Of the 24 dead cases 19 cases died of SARS,5 cases died of basal diseases.Conclusion The risk factors of SARS are age over 50,obvious decrease in early lymphocyte count.