目的:通过对甲型H1N1重症与危重症间各种因素的分析,明确影响甲流危重症发生的危险因素,为早期判断病情转归、积极进行临床干预提供参考。方法:回顾分析北京地坛医院等6家医院甲流重症及危重症患者病例279例,首先对患者的基本情况、病史、接触史、临床症状及用药情况进行单因素分析,初步确定危重症相关危险因素;然后通过多元Logistic回归分析最终确定影响甲型H1N1流感危重症发生的危险因素。结果:危重症患者中痰中带血、血糖异常发生率较高,血管活性药物的使用率增高。结论:痰中带血、血糖异常、血管活性药物的使用预示着危重症发生的危险增高。

This article is aimed to find risk factors that impact the onset of influenza A(H1N1) critical cases by analyzing the impact factors among severe and critical cases.Two hundred and seventy-nine diagnosed influenza A(H1N1) patients from six hospitals were included.Firstly,general information,onset of disease,disease history,symptoms and treatment were analyzed by one-way analysis of variance to find the relevant risk factors of critical cases.Then,risk factors that impact the onset of influenza A(H1N1) critical cases were determined by using logistic regression.The results showed that the onset ratio of bloody sputum,abnormal glucose were higher in critical cases than severe cases.The rate of using vasoactive drugs was also higher in both kinds of patients.It is concluded that the bloody sputum,abnormal glucose and vasoactive drug application might be risk factors that impact the onset of influenza A(H1N1) critical cases.

国家中医药管理局2009年行业专项(200907001-2A):甲型H1N1流感重症中医药治疗临床研究,负责人:毛羽,王玉光,国家中医药管理局2009年行业专项(200907001-4)中医药防治甲型H1N1流感、手足口病及流行性乙型脑炎的诊疗规律与机制研究,负责人:潘桂娟,吕爱平