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目的对影响重症肾综合征出血热(HFRS)的因素进行分析和评估,为HFRS患者预后进行科学的预则。方法 2003年1月至2012年12月本溪市传染病医院收治的HFRS患者202例,其中死亡31例(死亡组)和生存171例(生存组),比较两组在年龄、性别、职业、病程、病期重叠、血常规、生化指标、并发症上的差异。结果单因素分析显示年龄、病期重叠、血小板、总蛋白、白蛋白、肌酸磷酸肌酶、凝血酶原时间、钾离子、继发感染、ARDS、脑水肿、颅内出血、中毒性脑病、心力衰竭、DIC、抽搐与重症HFRS的预后有相关性(P<0.05或P<0.01)。多因素分析显示年龄、凝血酶原时间、中毒性脑病、颅内出血、ARDS是影响其预后的独立因素(P<0.05或P<0.01)。结论年龄、凝血酶原时间、中毒性脑病、颅内出血、ARDS是影响重症肾综合征出血热预后的独立因素,重视相关指标的动态监测,及时掌握病情变化及调整治疗,对改善患者预后、提高生存率具有重要意义。
Objective To analyze and evaluate the influencing factors of hemorrhagic fever with severe renal syndrome (HFRS), and to make scientific predictions for the prognosis of patients with HFRS. Methods From January 2003 to December 2012, 202 patients with HFRS admitted to the Infectious Diseases Hospital of Benxi City, including 31 deaths (death group) and 171 survivors (survival group), were compared in terms of age, sex, occupation, duration of disease , Overlapping stages, blood, biochemical indicators, complications on the difference. Results Univariate analysis showed that age, duration of overlap, platelet, total protein, albumin, creatine phosphokinase, prothrombin time, potassium, secondary infection, ARDS, cerebral edema, intracranial hemorrhage, toxic encephalopathy, heart failure , DIC, convulsion and the prognosis of severe HFRS (P <0.05 or P <0.01). Multivariate analysis showed that age, prothrombin time, toxic encephalopathy, intracranial hemorrhage and ARDS were independent prognostic factors (P <0.05 or P <0.01). Conclusions Age, prothrombin time, toxic encephalopathy, intracranial hemorrhage and ARDS are the independent factors affecting the prognosis of severe renal syndrome patients with hemorrhagic fever, and pay attention to the dynamic monitoring of relevant indicators, timely grasp of the changes of the disease and adjustment and treatment, and improve the prognosis of patients Survival rate is of great significance.