摘要
目的 研究SARS早期的临床特点。方法 对 5 3例SARS早期病例的流行病学、临床、实验室及影像学资料进行回顾性分析。结果 5 3例患者中男性 2 4例 ,女性 2 9例 ,平均年龄 (38±16 7)岁 (10～ 85岁 ) ,发病年龄以 2 0～ 5 0岁患者居多 (6 7 9% ) ,平均潜伏期 (7 3± 7 0 )d (3～ 14d) ,职业分布居多者为职员 (11例 ,占 2 0 8% ) ,其次是医护人员 (9例 ,17 0 % )。临床症状以发热 (10 0 % ) ,咳嗽 (49 1% ) ,肌肉酸痛 (2 4 5 % ) ,乏力 (17 0 % ) ,胸闷憋气 (2 0 8% ) ,腹泻 (5 7% )等为主要表现。在病程的第 1～ 5天患者白细胞 <4 0× 10 9 L 33例 (6 2 3% ) ,(4 0～ 10 0 )× 10 9 L 18例 (34 0 % ) ,6 7 9%患者淋巴细胞计数减少 ,13 2 %患者血小板计数减少。X线胸片主要病变呈肺部斑片状渗出性阴影 ,其中双侧受累占 15 1% ,单侧受累 75 4 %。血气分析示PO2 <90mmHg (1κPa =7.5mmHg) 2 6例 (占4 9 1% ) ,出现酸碱平衡紊乱者 9例 (17 0 % ) ,其中代谢性酸中毒 4例 (10 8% )及代谢性碱中毒合并呼吸性酸中毒 4例 (10 8% )。SARS常合并多脏器损伤 ,其中肝功能 (ALT、AST)异常占 37 7% ,肾功能(BUN、SCR)损伤占 11 3% ,心肌酶 (LDH、CK、HBDH)异常占 4 3 4 %。结?
Objective To elucidate the clinical features of patients at early stage of severe acute respiratory syndrome (SARS). Methods Fifty-three cases of early SARS were studied retrospectively. The data reviewed included those of epidemiology,clinical manifestations,laboratory investigation and roentgenology. Results The patients consisted of 24 men and 29 women,aged 10-85 years (mean 38±16.7 years),including 9 infected health-care professionals (17.0%). The mean incubation period was 7.3±7.0 days (3-14 days). The onset symptoms were characterized by fever (100%),cough (49.1%),maylgia (24.5%),shortness of breath (20.8%),malaise (17.0%),and diarrhea (5.7%). Routine blood test during the first to the fifth day of the disease revealed WBCs <4.0×10 9 /L in 33 patients(62.3%),4.0-10.0×10 9/L in 18 patients (34.0%),lymphopenia in 36 patients (67.9%),and PLT<100.0×10 9 in 7 patients(13.2%). The main abnormal X-ray finding was single (75.4%) or bilateral (15.1%) localized patchy clouding opacity. The decrease of arterial partial pressure of oxygen occurred in 26 patients (49.1%). The damage of several organs was common,including the elevated ALT or AST in 20 patients (37.7%),elevated BUN or SCR in 6 patients (11.3%) and elevated LDH or CK or HBDH in 23 patients (43.4%). Conclusion The clinical manifestations of SARS at the early stage were complex. The close monitoring of the blood cell counts,the blood gas analysis and chest radiography might be crucial to the early diagnosis.
出处
《中华实验和临床病毒学杂志》
CAS
CSCD
北大核心
2004年第1期73-75,共3页
Chinese Journal of Experimental and Clinical Virology
