摘要
目的 :研究严重急性呼吸综合征 (SARS)患者的临床特点与药物治疗方法。方法 :对深圳地区 46例SARS患者的临床表现、治疗及预后进行分析。结果 :①男∶女 =1.3∶1,平均 3 0 .5岁 ,儿童患者较少且一般不转为重症 ;孕妇及>45岁的中老年人易转为重症。②具有传染性强 ,家庭及单位易群体发病的流行病学特点。③所有患者均有发热 ,弛张热多见 ,平均发热病程 (9.0 7± 4.2 3 )d。多伴有呼吸道症状。胸部X线片示肺部炎症多于发热后 3～ 4d出现 ,平均持续(16.7± 10 .3 )d。易发生肝功能损害。CD+4 CD+8入院时平均为 (17.9± 5 .6) % (2 4.2± 6.5 ) % ,明显下降。④与普通患者比较 ,重症患者年龄大、热程长 ,双侧肺炎发生率高、炎症持续时间长 ,ALT升高发生率及升高程度较高 ,入院时CD+4细胞计数下降程度更明显 (P <0 .0 5 )。⑤易重症化 (4 7.3 % ) ,病死率为 4.3 %。易发生I型呼吸衰竭 (15 .2 % ) ,易发生肺纤维化 (17.4% )。⑥肺纤维化发生率与患者年龄、病情、胸腺肽α1 及短程肾上腺皮质激素使用有关。结论 :SARS患者的年龄大、热程长、双侧肺炎炎症持续时间长、肝功能损害、CD+4细胞计数明显下降等可作为早期判断SARS患者重症化的指标 ,胸腺肽α1
Objective:To study the clinical features of patients with SARS. Methods:Clinical manifestations, treatment and prognosis of 46 patients with confirmed diagnosis of SARS in the Shenzhen District were submitted to analysis. Results:①The ratio of male to female was 1.3 to 1, the mean age, 30.5 years. Childhood cases of the disease were relatively few and did not turn to be severe in general. Pregnant women and people over 45 years of age suffering from the disease were liable to develop severe consequences. ②High infectivity and aggregated invasion in families and organizations were some of the epidemiological characteristics. ③Fever, mostly remittent, was present in all cases, lasting (9.07±4.23) days in average, and was frequently associated with symptoms of the respiratory tract. Roentgenogtrams showed that pneumonia used to appear 3 to 4 days after the onset of fever, lasting in average (16.7±10.3) days. Disorders of the liver function were usually detected. A striking decrease in the CD + 4/CD + 8 cell count, with an average of (17.9±5.6)%/(24.2±6.5)% could be demonstrated on admission. ④In comparison with the conventional cases, severe cases of SARS were of more advanced age. Besides, severe cases had longer sustained fever, higher incidence of bilateral pneumonia of longer duration, higher rate and degree of sorum ALT elevation and greater extent of decrease in CD + 4 cell count on admission( P <0.05). ⑤47.3% of the conventional cases turned to be severe ones. The case fatality rate was 4.3%. Patients were prone to develop type Ⅰrespiratory failure(15.2%) and pulmonary fibrosis (17.4%). ⑥The incidence of pulmonary fibrosis was related to age, state of illness of the patient and application of thymosin α 1 as well as short term administration of adrenocortical hormone. Conclusion:The advanced age of the patient, the protracted course of fever, the presence of bilateral pneumonia of prolonged duration, evidences of liver function disorders and striking decrease in CD + 4 cell count may serve as early signs for the prediction that the patient is likely to develop serious consequences. The incidence of pulmonary fibrosis was lowered if thymosin α 1 and short term adrenocortical hormone had been administered.
出处
《医药导报》
CAS
2003年第12期832-834,共3页
Herald of Medicine
关键词
呼吸综合征
急性
严重
临床表现
药物治疗
预后
Sever acute respinadory syndrome(SARS)
Clinical feature
Drug treatment
Prognosis
