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目的 探讨严重急性呼吸综合征(SARS)患者发病后的入院时间与患者病情、病程以及病死率的关系。方法 将2003年“北京市SARS临床病历资料数据库”的1291例资料完整、符合卫生部2003年5月3日诊断标准的SARS临床诊断病例,按照发病后至收入院治疗时间的长短分为1～3天、4～7天、8～14天和15天以后入院4组进行分析。结果 4组之间年龄、性别和基础病构成差异无显著性,职业构成差异有显著性。入院越早,医务人员所占比例越高。在入院当日上述4组患者具有胸闷、胸痛的比例分别为9.7％、16.5％、23.1％和24.0％(P<0.001),气短憋气分别为7.4％、13.7％、19.2％和22.0％(P<0.001),咳嗽为32.8％、44.8％、59.9％和48.0％(P<0.001),呼吸次数≥24次/min者所占比例依次为11.1％、15.5％、22.8％和25.5％(P<0.001),胸片异常率依次为80.3％、89.0％。92.3％和88.9％(P=0.002),平均异常肺野数依次为1.7、1.9、2.5和2.6(P<0.001),接受持续吸氧治疗者分别为33.6％、50.0％、53.7％和74.0％(P<0.001),接受激素治疗者分别为28.2％、35.9％。53.7％和62.0％(P<0.001)。有基础病者的年龄标化病死率为14.9％、11.7％、50.0％和33.9％(P<0.001),平均病程为30.3天、34.2天、42.9天和47.5天(P<0.001);无基础病者的年龄标化病死率为5.3?
Objective To investigate the relationship between the hospitalization time and patient’s illness, course of disease and mortality after the onset of severe acute respiratory syndrome (SARS). Methods The data of 1291 cases of “Beijing SARS Clinical Medical Record Data Database” in 2003 were complete and accorded with the clinical diagnosis of SARS based on the diagnostic criteria of May 3, 2003 by the Ministry of Health. The patients were divided into 1 ~ 3 days, 4 to 7 days, 8 to 14 days and 15 days after admission four groups were analyzed. Results There was no significant difference in age, sex and basic disease among the 4 groups, and the difference in occupational composition was significant. The earlier admission, the higher the proportion of medical staff. The rates of chest tightness and chest pain were 9.7%, 16.5%, 23.1% and 24.0% on the day of admission (P <0.001), 7.4%, 13.7%, 19.2% and 22.0% 0.001), cough 32.8%, 44.8%, 59.9% and 48.0% (P <0.001), respiratory rate ≥24 beats / min followed by 11.1%, 15.5%, 22.8% and 25.5% ), Chest X-ray abnormalities were followed by 80.3%, 89.0%. 92.3%, and 88.9%, respectively (P = 0.002). The average number of abnormal lung fields were 1.7, 1.9, 2.5 and 2.6 (P <0.001), 28.2% and 35.9% of patients receiving hormone therapy respectively. 53.7% and 62.0% (P <0.001). The age-standardized case fatality rates for patients with underlying disease were 14.9%, 11.7%, 50.0%, and 33.9%, respectively (P <0.001), with an average duration of 30.3 days, 34.2 days, 42.9 days, and 47.5 days (P <0.001) The patient’s age-standardized case fatality rate is 5.3?