佛山市132例流行性出血热预后影响因素的分析

Study on the factors affecting the prognosis of epidemic hemorrhagic fever in Foshan city

目的探讨不同因素对流行性出血热预后的影响。方法分析132例流行性出血热病人,统计其病理资料,利用Cox比例风险模型对引起流行性出血热的病因相关数据进行回归分析,探讨影响流行性出血热预后的因素。结果入选病例中男67例,年龄9~72岁,平均年龄（39.8±2.3）岁;女65例,年龄8~69岁,平均年龄（38.7±1.8）岁。出现1种脏器损害的患者45例,其中肝脏损害17例,肾脏损害15例,心脏损害9例,肺损害4例;合并2种脏器损害患者76例,血液系统疾病24例,神经疾病10例,胃肠道疾病19例。脏器损害程度是影响流行性出血热预后的关键因素,多脏器功能障碍（MODS）是影响流行性出血热预后的主要危险因素。结论影响流行性出血热预后的因素有很多,其中MODS为主要致死因素,因此在临床治疗中要更加关注患者在MODS方面的情况。

Objective To investigate the influence of different factors on prognosis of epidemic hemorrhagic fever. Methods 132 cases of hemorrhagic fever were analyzed retrospectively using Cox regression model. Analysis the data of patients with epidemic hemorrhagic fever in our hospital during 2009-2004, Regression analysis of multi factors on the patients medical history, symptoms, clinical stage, urine volume changes, complications, EHF-IgM positive rate and organ damage degree were preformed to find the factors affecting the prognosis of epidemic hemorrhagic fever. Results 67 male patients were selected, aged from 9 to 72 years old, with a mean of （39.8±2.3）; 65 female cases were chosen, aged from 8 to 69 years old, with a mean of （38.7±1.8）. 45 patients had only one organ damage, including 17 cases of liver injury, 15 cases with renal damage, 9 cases with cardiac damage, 4 cases with pulmonary damage. 76 cases were two organ damages ; 24 cases were blood system diseases; 10 cases were neurological disease; 19 cases were gastrointestinal diseases. Organ damage degree is a key factor to affect the prognosis of epidemic hemorrhagic fever; multiple organ dysfunctions are the major risk factors for the prognosis of epidemic hemorrhagic fever. Conclusion There are many factors that affect the prognosis of epidemic hemorrhagic fever, where MODS is the major causes of death, so we should pay more attention to the patients in the MODS aspects of the situation in clinical treatment.