Zou Zhengsheng, Yang Yongping, Chen Jumei, Xin Shaojie, Zhang Wei, Zhou Xianzhi, Mao Yuanli, Hu Liangping, Liu Daojian, Chang Binxia, Chang Weihua, Liu Yanping, Ma Xuemei, Wang Yedong, Liu Xiqing
Department of Infectious Diseases, Beijing Infectious Disease Institute of People's Liberation Army, Beijing, China.
Clin Infect Dis. 2004 Feb 15;38(4):483-9. doi: 10.1086/380973. Epub 2004 Jan 28.
This study analyzes single factors that affect the prognosis of severe acute respiratory syndrome (SARS) and establishes a prognosis model by multivariate analysis. We retrospectively analyzed the clinical features of SARS in 165 clinically confirmed severe cases. Both age and existence of other diseases before SARS were significantly correlated with prognosis (r=0.506 and r=0.457, respectively; P<.001). During the acute phase of SARS, lactate dehydrogenase level, degree of hypoxemia, respiratory rate, alpha -hydroxybutyric dehydrogenase level, creatine kinase isoenzyme-MB, platelet count, and number of involved lobes noted on chest radiographs, and so on, correlated markedly with the prognosis (r=0.257-0.788; P<.05). The multivariate prognosis regression model was associated with degree of hypoxemia and platelet count. The model was defined by the formula Py=1=es/(1+es), where S is [2.490 x degree of hypoxemia]-[0.050 x number of platelets], and it had a high sensitivity (91.67%), specificity (98.33%), and accuracy (96.42%). The model could be used to effectively judge the state of illness and the prognosis.
本研究分析了影响严重急性呼吸综合征(SARS)预后的单因素,并通过多因素分析建立了预后模型。我们回顾性分析了165例临床确诊的重症SARS病例的临床特征。年龄和SARS发病前是否存在其他疾病均与预后显著相关(分别为r = 0.506和r = 0.457;P <.001)。在SARS急性期,乳酸脱氢酶水平、低氧血症程度、呼吸频率、α-羟丁酸脱氢酶水平、肌酸激酶同工酶-MB、血小板计数以及胸部X线片显示的受累肺叶数量等与预后显著相关(r = 0.257 - 0.788;P <.05)。多因素预后回归模型与低氧血症程度和血小板计数有关。该模型由公式Py = 1/(1 + es)定义,其中S为[2.490×低氧血症程度] - [0.050×血小板数量],其具有较高的敏感性(91.67%)、特异性(98.33%)和准确性(96.42%)。该模型可用于有效判断病情状态和预后。