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目的调查国内多器官功能障碍综合征(MODS)患者急性呼吸窘迫综合征(ARDS)的流行病学情况。方法采用多中心、前瞻性调查方法,分析2002年3月至2005年1月全国11省市、37家三级医院1087例MODS患者的病例情况。结果1087例患者中,ARDS的发生率、病死率分别为61.2%、63.6%。其中入住ICU患者其28天病死率为57.9%。MODS患者ARDS发生及死亡的高危因素分别为系统炎性反应综合征(SIRS)、MODS总评分,高龄、Glasgow言语反应总评分等等。与其发生与否相关的实验室检查有外周血白细胞总数及动脉血氧浓度测定。结论MODS患者中ARDS发生率较高,其发生及死亡高危因素有高龄、全身炎症反应综合征等。患有ARDS的MODS患者的ICU28天死亡率较无ARDS患者要高。
Objective To investigate the epidemiology of acute respiratory distress syndrome (ARDS) in patients with multiple organ dysfunction syndrome (MODS) in China. Methods A multicenter, prospective investigation was conducted to analyze the incidence of MODS in 1087 patients from 11 provinces, cities and 37 tertiary hospitals from March 2002 to January 2005. Results Among 1087 patients, the incidence and mortality of ARDS were 61.2% and 63.6% respectively. Among them, the 28-day mortality of ICU patients was 57.9%. The risk factors of ARDS and death in patients with MODS were systemic inflammatory response syndrome (SIRS), MODS total score, advanced age, Glasgow speech response total score and so on. Laboratory tests related to their occurrence or not have the total number of peripheral leukocytes and arterial oxygen concentration determination. Conclusion The incidence of ARDS in patients with MODS is high, and the high risk factors for their occurrence and death are advanced age and systemic inflammatory response syndrome. MODS patients with ARDS have a 28-day mortality rate higher than those without ARDS.