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目的:分析结缔组织病(connective tissue diseases,CTDs)住院患者在10年期间死亡原因等的变化趋势。方法:采用回顾性分析的方法,收集中南大学湘雅医院风湿免疫科在2005年1月1日至2014年12月31日期间,确诊的CTDs住院患者中所有死亡病例的所有临床资料。结果:10年期间CTDs住院患者的总体住院病死率为15.68‰。在CTDs患者的3大类死亡原因中,疾病本身占44.71%,感染占42.94%,合并症占12.35%。其中,疾病本身的死因构成比和住院病死率呈逐年下降趋势,感染和合并症的死因构成比呈逐年上升趋势。2013—2014年,感染成为最主要的死亡原因,其死因构成比为51.06%。合并肺间质病变的CTDs患者与没有合并肺间质病变的CTDs患者相比,前者的生存时间明显缩短,其死亡风险是后者的1.722倍。在各种CTDs中,特发性炎性肌病患者的总住院病死率最高(45.98‰),系统性硬化症和系统性红斑狼疮患者的因疾病本身死亡比例最高,特发性炎性肌病患者的因感染死亡比例最高,类风湿关节炎的患者因合并症死亡比例最高。结论:在CTDs住院患者中,因疾病本身导致死亡的死因构成比和住院病死率均呈逐年下降趋势;因感染和合并症导致死亡的死因构成比呈逐年上升趋势,且感染成为第一位死因。CTDs合并肺间质病变患者生存时间缩短,死亡风险增加。
Objective: To analyze the change trend of death causes of hospitalized patients with connective tissue diseases (CTDs) during 10 years. Methods: A retrospective analysis was conducted to collect all the clinical data of all deaths from hospitalized patients with CTDs diagnosed between January 1, 2005, and December 31, 2014, Department of Rheumatology, Xiangya Hospital, Central South University. Results: The overall in-hospital mortality rate of hospitalized patients with CTDs was 15.68 ‰ during 10 years. Of the three major causes of death in patients with CTDs, the disease itself accounted for 44.71%, infections 42.94%, and comorbidities 12.35%. Among them, the cause of death of the disease composition and in-hospital mortality showed a downward trend year by year, the cause of infection and complications constitute a rising trend year by year. In 2013-2014, infection became the leading cause of death with a death rate of 51.06%. Compared with CTDs without pulmonary interstitial disease in CTDs patients with interstitial lung disease, the survival time was significantly shortened and the risk of death was 1.722 times of the latter. In all CTDs, the highest overall hospital mortality in idiopathic inflammatory myopathies (45.98 ‰), systemic sclerosis and systemic lupus erythematosus in patients with the highest proportion of deaths due to disease, idiopathic inflammatory myopathy The highest proportion of deaths due to infection in patients, patients with rheumatoid arthritis, the highest proportion of deaths due to complications. Conclusion: In-hospital mortality of patients with CTDs causes a declining trend in the proportion of death causes and in-hospital mortality rates. The proportion of death causes due to infection and complications has been increasing year by year, and infection has become the first cause of death . Patients with CTDs and interstitial lung disease have shorter survival and increased risk of death.