摘要目的:分析201例急诊成年猝死患者的临床资料，并研究白细胞计数、动脉血乳酸浓度对预后的影响。方法:回顾性分析2017年1月至2021年1月河北省沧州市人民医院医专院区急诊科诊断为猝死的201例患者临床资料，对患者性别、年龄、疾病构成、病因等进行统计分析。符合正态分布的计量资料组间比较采用独立样本 t检验，计数资料组间比较采用χ 2检验或Fisher确切概率法，采用Logistic回归模型筛选急诊死亡的危险因素，并分析白细胞计数、动脉血乳酸水平对预后的影响。 结果:经过积极抢救，抢救成功11.44％（23/201），抢救无效88.56%（178/201）；≥46~≤65岁为猝死高发年龄段［55.22%（111/201）］，≥46~≤65岁年龄段及>65岁年龄段内，男性占比［43.28%（87/201）、20.90%（42/201）］均高于女性［11.94%（24/201）、14.43%（29/201）］，差异有统计学意义（χ 2值分别为4.801、9.209； P值分别为0.028、0.002）；猝死患者既往史中，心血管疾病占比［53.23%（107/201）］最高；猝死前可能存在诱因患者占比74.13%（149/201），猝死前有先兆症状的患者占比67.66%（136/201），心源性猝死为首位病因；Logistic回归分析显示，白细胞计数（ OR=4.442，95% CI：1.898~10.395）、动脉血乳酸浓度（ OR=4.272，95% CI：2.024~9.016）、白蛋白浓度（ OR=2.657，95% CI：1.302~5.422）是影响急诊猝死患者的独立危险因素（ P值分别为0.001、<0.001、0.007）。 结论:成人猝死患者在性别、年龄、既往史方面存在一定差异，多数存在先兆症状与诱因，心源性猝死为首要病因。白细胞计数及动脉血乳酸浓度升高、白蛋白浓度降低是急诊患者猝死的危险因素。

abstractsObjective:To investigate the clinical situation of 201 emergency adult sudden death patients, and analyze the influence of white blood cell count and arterial blood lactate level on prognosis.Methods:The clinical data of 201 patients diagnosed with sudden death in the emergency department of Medical College of Cangzhou people's Hospital from January 2017 to January 2021 were retrospectively analyzed. The gender, age, disease composition and etiology of the patients were statistically analyzed. The independent sample t-test was used to compare the measurement data with normal distribution, the χ 2 test or Fisher exact probability method was used to compare the counting data between groups, and the logistic regression model was used to screen the risk factors of emergency death, and the impact of white blood cell count and arterial blood lactate level on the prognosis was analyzed. Results:After active rescue, 11.44% (23/201) of the patients were successfully rescued, and 88.56% (178/201) of the patients were ineffective; ≥46-≤65 years old was the age group with high incidence of sudden death (55.22%(111/201)). The proportion of male (43.28% (87/201), 23.38% (42/201)) in the age group of ≥46-≤65 years old and the age group over 65 years old were higher than that of female (11.94% (24/201), 14.43% (29/201)), with a statistically significant difference (χ 2=4.801, 9.209; P=0.028, 0.002). In the past history of sudden death patients, the proportion of cardiovascular disease (53.23% (107/201)) was the highest; the proportion of patients may have inducements before sudden death was 74.13% (149/201), the proportion of patients have premonitory symptoms before sudden death was 67.66% (136/201), and sudden cardiac death was the first cause. Logistic regression analysis showed that white blood cell count ( OR=4.442,95% CI: 1.898-10.395), arterial blood lactic acid concentration ( OR=4.272,95% CI: 2.024-9.016), and albumin concentration ( OR=2.657,95% CI: 1.302-5.422) were independent risk factors affecting emergency sudden death patients ( P values were 0.001, <0.001, 0.007, respectively). Conclusions:There are some differences in gender, age and past history of adult sudden death patients. Most of them have premonitory symptoms and inducements. Sudden cardiac death is the primary cause. The increases of white blood cell count and lactic acid level, the decrease of albumin level are the risk factors of sudden death.