Objective To investigate the characteristics of clinical manifestations of severe cases with influenza A H1N1 and sieve the risk factors causing death of the disease in Xinjiang. Methods The clinical data of 161 cases with severe influenza A H1N1 in Xinjiang from October 14, 2009 to January 14, 2010 were retrospectively analyzed. According to clinical outcome, the patients were divided into a death group (12 cases) and a survival group (149 cases). The case information database was established to record gender,age, nationality, referral number, underlying diseases, the number of days of morbidity at the first diagnosis,maximum temperature, duration of fever, organ dysfunction, the need for mechanical ventilation and the total disease course and prognosis. The multi-factor screening of risk factors related to death was analyzed by multivariable Logistic regression. Results One hundred and sixty-one patients received Tamiflu after the final confirmed diagnosis by throat swab detection, and of them 60 patients received Tamifiu at first diagnosis.Twenty-three patients underwent the mechanical ventilation. The patients with severe symptoms were often those with chronic basic diseases, the flu symptoms being the primary manifestations, the involved multiple organs were lung, heart, liver, kidney and nervous system; after treatment, there were 12 patients dead and 149 patients improved and discharged. The results of multivariable Logistic regression showed that cardiovascular disease as the fundamental disease, duration of fever, cardiac, renal and nervous system involvement were independent risk factors related to patients' death [relative odds ratio (OR) was 20. 667,1. 445, 18. 185, 46. 142, 158. 156, respectively; the 95％ confidence interval (95％CI) was 2. 405 - 177. 784,1. 086 - 1. 950, 1. 140 - 290. 062, 6. 344 - 335. 587, 4. 270 - 5 858. 255, and the P value was 0. 006, 0. 012,0. 040, 0. 000, 0. 006, respectively]. Conclusion Cardiovascular disease, duration of fever, cardiac, renal and nervous system involvement are independent risk factors related to the death in severe cases with influenza A H1N1 in Xinjiang.%目的 观察生脉注射液对不同类型休克患者血流动力学的影响,并分析其意义.方法 回顾性分析2009年10月14日至2010年1月14日新疆各地发生的161例重症甲型H1N1流感病例的临床资料,按临床转归将患者分为死亡组(12例)和存活组(149例).建立患者个案信息库,记录性别、年龄、少数民族例数、转诊次数、基础疾病、首诊时发病天数、最高体温、发热持续时间、器官功能异常、是否需要机械通气、病程总天数及预后;采用多元逐步Logistic回归法筛选重症患者的死亡相关危险因素.结果 161例患者在咽拭子标本检测确诊后使用奥司他韦(达菲),其中60例患者首诊即使用达菲.23例患者行机械通气.重症患者常发生在有慢性病者中,以流感样症状为主,受累器官多为肺、心、肝、肾、神经系统.12例死亡,149例好转出院.多因素Logistic回归分析显示,基础疾病为心血管疾病、发热持续天数以及心脏、肾脏、神经系统受累是患者死亡的独立危险因素(相对比值比(OR)分别为20.667、1.445、18.185、46.142、158.156;95%可信区间(95%CI)分别为2.405～177.784、1.086～1.950、1.140～290.062、6.344～335.587、4.270～5858.255,P值分别为0.006、0.012、0.040、0.000、0.006).结论 心血管疾病、发热持续天数及心脏、肾脏、神经系统受累是影响新疆重症甲型H1N1流感患者死亡的独立危险因素.
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