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目的 :研究SARS合并糖尿病死亡原因。方法 :以我院 2 0 0 3年 4~ 6月收治的SARS合并糖尿病的 4 6例患者为研究对象 ,分为死亡组 (A组 )及治愈组 (B组 )。比较两组的生化指标、血氧饱和度 (SpO2 )、胸片、多器官功能衰竭 (MODS)、二重感染、激素用量、血常规以及CD3+ ,CD4 + ,CD8+ T淋巴细胞计数等。结果 :①A组丙氨酸转氨酶(ALT) ,尿素氮 (BUN) ,血清肌酸激酶 (CK) ,乳酸脱氢酶 (LDH)显著高于B组 (P <0 .0 1)。②A组SpO2 <95 % ,合并MODS ,二重感染及糖皮质激素日均用量≥ 16 0mg/d的例数均明显多于B组 (P <0 .0 5 )。③A组血小板 ,淋巴细胞 ,CD3+ ,CD4 + ,CD8+ T淋巴细胞计数显著低于B组 (P分别 <0 .0 1,0 .0 5 ,0 .0 0 1)。结论 :SARS合并糖尿病患者的死亡原因与肺损害、低氧血症、MODS、二重感染及激素用量密切相关。
Objective: To investigate the causes of death from SARS with diabetes. Methods: A total of 46 patients with SARS with diabetes mellitus admitted from April to June in 2003 were divided into death group (A group) and cured group (B group). The biochemical indexes, blood oxygen saturation (SpO2), chest radiograph, multiple organ failure (MODS), double infection, hormone dosage, blood routine and CD3 +, CD4 +, CD8 + T lymphocyte count were compared between the two groups. Results: ① The levels of ALT, BUN, CK and LDH in group A were significantly higher than those in group B (P <0.01). ② The cases of SpO2 <95%, combined MODS, double infection and daily average glucocorticoid dosage ≥ 160mg / d in group A were significantly more than those in group B (P <0.05). ③ The counts of platelet, lymphocyte, CD3 +, CD4 +, CD8 + T lymphocyte in group A were significantly lower than those in group B (P <0.010,0.0,0.001). Conclusion: The causes of death in patients with SARS complicated with diabetes are closely related to lung injury, hypoxemia, MODS, double infection and hormone dosage.