目的 :通过分析 12 6例急性心源性肺水肿患者与预后不良相关的因素 ,试图找出临床表现、对治疗的早期反应与院内及 5个月病死率之间的联系。方法 :12 6例急性心源性肺水肿患者 ,经过 5个月随访的前瞻性研究。结果 :多变量分析表明院内病死率与大理石状纹理 ( RR=7.3)、少尿 ( RR=4.0 3)、入院后 6小时呼吸频率高 ( RR=4.4)、长期服用地高辛 ( RR=3.6 )有关 ;5个月病死率与长期卧床 ( RR=8.6 )、大理石状纹理 ( RR=5 .5 )、心肌梗塞( RR=3.2 )、早期治疗反应差 ( RR=3.2 )有关。结论 :除了公认的因素外 ,本研究亦揭示了其它预后不良因子 ,并指出入院 6小时后评价对早期治疗的反应是决定预后的主要因素 OBJECTIVE: To identify the association between clinical manifestations, early response to treatment, and hospital and 5-month mortality by analyzing factors associated with poor prognosis in 126 patients with acute cardiogenic pulmonary edema. Methods: A prospective study of 126 patients with acute cardiogenic pulmonary edema after 5 months follow-up. Results: Multivariate analysis showed that the hospital mortality was related to the marbled texture (RR = 7.3), oliguria (RR = 4.03), high respiratory rate at 6 hours after admission (RR = 4.4) ). The 5-month mortality was related to long-term bed rest (RR = 8.6), marbled texture (RR = 5.5), myocardial infarction (RR = 3.2) and poor response to early treatment (RR = 3.2). CONCLUSIONS: In addition to the well-established factors, this study also revealed other adverse prognostic factors and noted that the assessment of response to early treatment 6 hours after admission is the major determinant of prognosis