摘要
目的了解SARS的临床特点,探索有效的治疗方法。方法对74例患者进行回顾性分析。结果男27例,女47例,女性发病人数显著多于男性,年龄最小者6岁,最大者78岁,77%的病人年龄处于20～45岁之间,平均33±10岁;病人都有发热(100%),以发热为首发症状者92%,多数病人有畏寒(78%),伴头痛、肌肉痛(66%)、胸闷憋气(51%),肺部有罗音者较少(18%)。实验室检查:2周内WBC、L、PLT可降低,其中以淋巴细胞降低最为明显,达76%。发病1周内氧分压低于90mmHg者82%;胸片为单侧局部者为48%,单侧多叶者为23%,双侧者为29%。症状与体征不一致,症状早于体征2～4天,胸闷明显期为发病后4～15天,高热期为发病后2～14天。临床治疗以小剂量糖皮质激素(40～160mg,q12h)、氧疗、抗病毒药、大环内酯类、头孢类抗生素、免疫调节剂及对症治疗为主。结论SARS以高热、肺片状损伤为主,免疫系统受到明显损伤,女性多于男性,T细胞亚群的测定有利于早期诊断,早期氧疗、小剂量激素治疗有利于控制病情。
Objective To investigate the clinical characters of SARS and find out effective treatment for it. Methods To analyze 74 cases of SARS retrospectively. Results There were 47 females and 27 males in the cohort, more women than men, age ranging from 6 to 78 years old. 77%patients'age ranges from 20 to 45, the average was 33±10 years. All the cases had fever (100%), There were about 92%of the cases whose first symptom was fever. Most cases had chills (78%),headache and muscle pain, difficult to breathe(51%), voice of moist in lung(18%).Lab test: The number of WBC,L and PLT could be lower in two weeks, and especially in L(76%),PO2<90mmHg(82%)in first week, local destroyed site in one side in X-ray (48%), several lobes in one side (23%), two side (29%). The symptoms were usually not content with the expression of the body, the symptoms could be earlier for 2 to 4 days, breathless could take place in the 4 to 15 days, high temperature period was 2 to 14 days. Clinical treatments include small amount hormone, O2 therapy, anti-virus, antibiotics, immunity intensity drugs, and so on. Conclusion SARS's feature include high temperature, destroy site in lung, destroy of immunity system, there were more women patients than men, the test of T sub-clone is useful for the earlier diagnosis of SARS.Earlier oxygen treatment and small amount of hormone were useful to control the disease.
出处
《中国航天医药杂志》
2003年第6期4-6,共3页
Medical Journal of CASE
