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目的探讨严重急性呼吸综合征(SARS)患者流行病学诊断依据与病死率的关系。方法回顾性分析临床诊断的304例SARS患者的流行病学证据(包括传播他人病例、群发病例和散发病例),对其与预后的关系进行统计分析。结果SARS患者病死率为8.2%,不同流行病学诊断依据与病死率的关系显示,散发、群发和传播他人的患者有病死率增加的趋势穴病死率分别为3.9%、11.4%和17.2%熏χ2trend=7.561熏P<0.01雪;经趋势卡方检验,SARS的病死率随年龄的增大而显著升高(χ2trend=27.024熏P<0.01);男性大于女性(12.2%vs5.5%)。多元Logistic回归模型显示,流行病学暴露水平、年龄和性别是影响预后的因素。前进法观察流行病学暴露水平、年龄、性别OR值的动态变化,发现流行病学暴露水平是独立的与SARS患者死亡相关的预后因素。结论流行病学诊断依据是与SARS患者病死率有关的独立预后因素,具有传播他人史的SARS患者较散发和群发病例预后差,病死率高。
Objective To investigate the relationship between epidemiological diagnosis and mortality of patients with severe acute respiratory syndrome (SARS). Methods Retrospective analysis of epidemiological evidence (including the spread of other cases, mass cases and sporadic cases) in 304 clinically diagnosed cases of SARS was performed, and their relationship with prognosis was statistically analyzed. Results The mortality rate of SARS patients was 8.2%. According to the relationship between the different epidemiological diagnosis and mortality, the case fatality rate of 3.9%, 11.4% and 17.2% respectively χ2trend = 7.561 smoked P <0.01 snow; by chi-square test, the case fatality rate of SARS was significantly increased with age (χ2trend = 27.024 smoked P <0.01); men than women (12.2% vs5.5%). Multivariate logistic regression models showed that the level of epidemiological exposure, age and gender were the factors that affected the prognosis. The advancing method observes the dynamic changes of epidemiological exposure level, age and sex OR value, and finds that the epidemiological exposure level is an independent prognostic factor related to the death of SARS patients. Conclusions The basis of epidemiological diagnosis is an independent prognostic factor related to the mortality of patients with SARS. Patients with SARS who have transmitted other people’s history have worse prognosis and high mortality rate than those with sporadic cases.