婴儿捂热综合征死亡的危险因素

Risk Factors of Death in Infant with Muggy Syndrome

目的探讨婴儿捂热综合征(IMS)死亡的危险因素。方法回顾性分析2002年1月-2007年2月63例IMS患儿的临床资料,按照是否并代谢性酸中毒、高血糖、低血钙、超高热,及儿童危重病例评分(PCIS)、脏器衰竭数目对患儿进行分组,对各项危险因素行χ2检验,比较组间患儿的病死率。结果63例患儿住院期间病死率为22.1%。并代谢性酸中毒与未并代谢性酸中毒患儿病死率比较差异有统计学意义(RR=3.20,95%CI=1.0～10.24,χ2=4.76P<0.05),且病死率随着血pH降低而升高(Pearson列联系数=0.49,χ2=9.80P<0.05)。存活48例与15例死亡患儿PCIS评分相比有显著差异(t=7.798P<0.05)。PCIS≤80分与>80分患儿的病死率相比有显著差异(RR=12.73,95%CI=1.78～91.04,χ2=13.24P<0.05)。血糖>12mmol/L的患儿与血糖<12mmol/L的患儿相比差异有统计学意义(RR=3.73,95%CI=1.46～9.54,χ2=8.73P<0.05)。并低血钙与未并低血钙的患儿病死率相比有显著差异(RR=3.0,95%CI=1.23～7.31,χ2=6.30P<0.05)。体温≥41℃与体温<41℃的患儿病死率相比有显著差异(RR=3.0,95%CI=1.34～6.74,χ2=3.97P<0.05)。脏器衰竭≥3个与脏器衰竭<3个的患儿病死率相比有显著差异(RR=7.88,95%CI=2.85～21.78,χ2=17.66P<0.05)。结论代谢性酸中毒、高血糖、低血钙、超高热、低PCIS评分及多脏器衰竭可能是IMS的死亡危险因素。

Objective To explore the risk factors of death in infant with muggy syndrome （IMS）, Methods Sixty - three children with Ibis were analyzed retrospectively, who admitted from Jan. 2002 to Feb. 2007, and these children were divided into groups according to the presence or absence of combined conditions including metabolic acidosis, hyperglycemia, hypocalcemia, uhrabyperpyrexia, pediatric critical illness seore（PCIS） or number of the multiple organs failure. The χ^2test was used to examine the mortality between those groups. Results The total mortality of these children with IMS in - hospital was 22.1%. There were significant differences in mortality between combining metabolic acidosis and non - combining ones （RR = 3. 20,95% CI = 1.0 - 10.24 χ^2 = 4.76 P 〈 0.05 ）, and the mortality was increasing along with the pH declining （ Pearson coeffw/ent = 0.49, χ^2 = 9.80 P 〈 0. 05 ）. The mean PCIS in the 48 suervivors and 15 dead had significant differences （ t = 7. 798 P 〈 0.05 ）. There were significant differences of mortality between children with PCIS≤ 80 score and children with PCIS 〉80score（RR=12.73,95%CI=1.78-91.04,χ^2=13.24 P〈0.05）. There were significant differences of mortality between childrenwithblosdgtucose 〉12mmol/Landthose〈12mmol/Lones（RR=3.73,95%CI=1.46-9.54,χ^2=8.73 P〈0.05）. Therewere significant differences of mortality between groups of combining hypocaleemia and non - combining ones （ RR = 3. 0,95 % CI = 1.23 - 7.31, χ^2 = 6, 30 P 〈 0.05 ）. There were significant differences of mortality between groups of children with body temperature ≥41 ℃ and 〈 41℃ ones（RR=3.0,95%CI=1.34-6.74, χ^2 =3.97 P〈0.05）. There were significant differences of mortality between groups of children with more than 3 organs failure and ones with less than 3 organs failure （RR = 7.88,95% CI = 2.85 - 21.78 ,χ^2 = 17.66 P 〈 0.05）. Conduslon Metabolic acidosis, hypergiycemia, hypocalcemia, ultrahyperpyrexia, PCIS and the number of the organ nonfunction may be the risk factors of IMS.