SARS合并ARDS患者死亡高危因素分析

Death risk factors of severe acute respirotary syndrome with acute respiratory distress syndrome

目的 :了解严重急性呼吸综合征 (SARS)合并急性呼吸窘迫综合征 (ARDS)患者死亡的高危因素 ,为制定相应的防治措施作参考 ,以期降低病死率。方法 :以我院中心 ICU收治的 2 5例 SARS合并 ARDS患者为对象 ,采用回顾性研究方法 ,用 SPSS10 .0统计软件作 L ogistic回归 ,筛选和分析死亡的危险因素。结果 :筛选出年龄、缺氧持续的时间、血小板减少、高血钠、血肌酐升高 5个死亡危险因素 ,其相对危险度分别为 1.2 0 3、1.0 6 7、111.932、2 6 .6 6 7和 111.932。结论 :应重视并针对死亡的危险因素制订相应的防治措施 ,降低病死率。

Objective: To discuss the possible death risk factors of severe acute respiratory syndrome(SARS) with acute respiratory distress syndrome (ARDS). Methods:Twentyfive patients surfffered from SARS with ARDS in the intensive care unit were retrospectively analyzed from December 2002 to April 2003. Statistical analysis was made using SPSS 10.0 and forward stepwise (wald) logistic regression analysis were used to determine the interrelationships between multiple variables and death. P <0 05 was considered statistically significant.Results:The following factors were associated with a significantly higher mortality rate in the SARS with ARDS patients,including age increase(OR=1 203, CI =1 036 to 1 396, P =0 016), longtime hypoxia(OR=1 067, CI =1 014 to 1 122, P =0 013), thrombocytopenia(OR=111 932, CI =6 096 to 2 055 252, P =0 001), hypernatremia(OR=26 667, CI =2 242 to 317 147, P =0 009), and elevation of serum creatinine levels (OR=111 932, CI =6 096 to 2 055 252, P =0 001). Conclusion:More attention should be paid to deal with these risk factors and to prevent the development of serious complications associated with SARS.