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为分析严重急性呼吸综合征(SARS)死亡患者的临床特征、治疗及死亡相关因素,对2003年5月6日至6月27日收治的220例SARS患者中19例死亡患者的临床、实验室、影像学资料、临床治疗及死亡相关因素进行回顾性分析。结果19例死亡SARS患者年龄24～86岁,平均(57.63±16.76)岁。大于45岁13例(68.4%)。男性15例(78.9%),女性4例(21.1%)。有明确接触史19例(100%)。并存基础病13例(68.4%)。死亡距发病时间14～54d,平均(35.37±11.66)d。临床表现主要有发热19例(100%),咳嗽12例(63.2%),畏寒5例(26.3%),气促10例(52.6%),胸闷11例(57.9%),肌痛5例(26.3%),腹泻6例(31.6%)。实验室检查血常规中早期白细胞总数正常或降低,淋巴细胞降低。血气分析低氧血症16例(84.2%);心肌酶肌酸激酶心肌型同工酶(CKMB)、乳酸脱氢酶(LDH)、α羟丁酸脱氢酶(HBDH)随病情的严重程度而进行性升高。T细胞亚群CD3、CD4、CD8绝对值随病情的严重程度而进行性降低。胸部X线双侧、肺病变面积>1/3者19例(100%)。临床诊断继发混合感染(细菌、真菌)19例(100%)。采用综合治疗,其中激素18例(94.7%)、机械通气15例(78.9%)。死于呼吸衰竭18例(94.7%)。提示年龄、合并基础病、肺部病变程度、低氧血症、T细胞亚群CD3、CD4绝对值降低、激素剂量、混合感染等是影响S
To analyze the clinical characteristics, treatment and mortality-related factors of death in patients with Severe Acute Respiratory Syndrome (SARS), the clinical and laboratory data of 19 deaths from 220 SARS patients admitted from May 6 to June 27, 2003 , Imaging data, clinical treatment and death-related factors were retrospectively analyzed. Results 19 patients died of SARS aged 24 to 86 years, with an average (57.63 ± 16.76) years. 13 cases (68.4%) were older than 45 years old. There were 15 males (78.9%) and 4 females (21.1%). A clear history of exposure to 19 cases (100%). There were 13 cases (68.4%) of coexisting basic diseases. Mortality from the onset time 14 ~ 54d, with an average (35.37 ± 11.66) d. The main clinical manifestations were fever in 19 cases (100%), cough in 12 cases (63.2%), chills in 5 cases (26.3%), shortness of breath in 10 cases (52.6%), chest tightness in 11 cases (57.9% (26.3%) and 6 cases (31.6%) of diarrhea. Laboratory tests routine white blood cell count in the early normal or decreased lymphocytes decreased. Blood gas analysis of 16 cases of hypoxemia (84.2%); myocardial enzymes CKMB, LDH, HBDH with the severity of the disease And progressive increase. T cell subsets CD3, CD4, CD8 absolute decline with the severity of the disease. Chest X-ray bilateral lung lesions area> 1/3 in 19 cases (100%). Clinical diagnosis of secondary mixed infection (bacteria, fungi) in 19 cases (100%). A comprehensive treatment, including 18 cases of hormone (94.7%), mechanical ventilation in 15 cases (78.9%). 18 died of respiratory failure (94.7%). Prompted age, combined basic disease, lung disease, hypoxemia, T cell subsets CD3, CD4 absolute decline, hormone dose, mixed infection is the impact of S