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目的 研究心脑血管基础疾病与严重急性呼吸综合征(SARS)患者与SARS病情和发生多器官功能障碍综合征(MODS)的关系。方法 分析2003年北京市1291例SARS患者的病历资料,分别用卡方检验和Logistic回归分析比较既往无基础疾病、有其他基础疾病和有心脑血管基础疾病3组SARS患者重症患者所占比例和MODS的发生率。结果 SARS患者总的重症构成比和MODS的发生率分别是34.86％和13.71％。既往无基础病、有其他基础病和有心脑血管病的SARS患者重症构成比和MODS发生率分别为28.10％、43.70％、58.18％和9.83％、18.52％、27.27％。3组比较差异均有显著意义(P<0.0001)。Logistic回归分析表明,在调整年龄和职业后,合并有心脑血管病的患者发生重症SARS和MODS的危险分别是无基础病者的1.819倍和1.974倍(OR=1.819,95％可信区间=1.276-2.592;OR=1.974,95％可信区间=1.273-3.060),差异均有显著意义(P<0.05)。结论 心脑血管基础疾病是SARS患者病情演化成发生重症和MODS的重要危险因素。
Objective To investigate the relationship between SARS patients’ condition and multiple organ dysfunction syndrome (MODS) in patients with cardiocerebrovascular diseases and severe acute respiratory syndrome (SARS). Methods The data of 1291 cases of SARS in Beijing from 2003 to 2003 were analyzed. Chi-square test and Logistic regression analysis were used to compare the proportion of severe cases with no underlying diseases, other underlying diseases and those with SARS The incidence of MODS. Results The total severe constitutional ratio and the incidence of MODS in SARS patients were 34.86% and 13.71% respectively. In the past, there was no underlying disease. The rates of severe disease and MODS were 28.10%, 43.70%, 58.18% and 9.83%, 18.52% and 27.27% respectively in SARS patients with other underlying diseases and with cardiovascular and cerebrovascular diseases. Three groups were significant differences (P <0.0001). Logistic regression analysis showed that the risk of severe SARS and MODS in patients with cardiovascular and cerebrovascular diseases after adjusting for age and occupation were 1.819 times and 1.974 times higher than those without basic disease (OR = 1.819, 95% CI = 1.276-2.592; OR = 1.974, 95% confidence interval = 1.273-3.060), the difference was significant (P <0.05). Conclusions Cardiovascular and cerebrovascular diseases are the important risk factors for SARS patients to develop severe disease and MODS.