北京409例SARS 病人的呼吸系统症状分析

目的分析传染性非典型肺炎的呼吸系统症状学的特点。方法回顾性分析北京地区6家SARS定点医院收治的409例传染性非典型肺炎病例的临床资料。结果409例临床确诊的SARS患者的呼吸系统症状中以咳嗽为最主要表现(306例，7418％)，其次为胸闷(221例，54．0％)、咯痰(202例，49．4％)，血丝痰最少见(46例，11．2％)。呼吸系统症状在病程第1d的出现率最高，咳嗽、咯痰、血丝痰、胸闷、胸痛的出现率分别为：45．09％(138例／306例)、30．2％(61例／202例)、15．22％(7例／46例)、23．98％(53例／221例)、17．91％(12例／67例)。在病程第8d上述症状的出现率出现第二峰。各呼吸系统症状与血象、胸片的严重程度之间似乎无明显的相关性。结论SARS是SARS-CoV所致的新型烈性传染病，肺为该病毒攻击的主要靶器官，呼吸系统症状是SARS的主要临床表现，其中以咳嗽为最常见，次之为胸闷、咯痰，以血丝痰最少见。目前尚无早期确诊SARS的金标准，也没有针对该病毒的特异性治疗方法；流行病学资料及临床特征是早期诊断的主要依据。

Analysis of Respiratory Symptoms in 409 Patients with Severe Acute Respiratory Syndrome

Objective To analyze the characteristic of respiratory symptoms in patients with SARS. Methods 409 SARS patients' clinical characters were reviewed retrospectively. These patients were admitted in Beijing's 6 fixed hospitals. (Results)Cough was the most common respiratory symptom(306 cases, 74.8%), followed by dyspnea (221 cases, 54.0%), expectoration (202 cases, 49.4%), and the least respiratory symptom was expectoration with blood streak sputum (46 cases , 11.2%). All respiratory symptoms were appeared most commonly at the first day during the course of SARS: at the first day, the appearance ration of cough, expectoration, expectoration with blood streak sputum, dyspnea, chest pain was 45.09%(138 cases to 306 cases), 30.2%(61 cases to 221 cases), 15.22%(7 cases to 46 cases ), 23.98%(53 cases to 221 cases ), 17.91%(12 cases to 67 cases )in turn. All respiratory symptoms were appeared second commonly at the 8th day during the course of SARS. Fever and the respiratory symptoms were the main manifestations of SARS. All respiratory symptoms were appeared most commonly at the first pyretic day, and they were appeared second commonly at the 8th pyretic day, too. It seems that all respiratory symptoms were not related obviously with the WBC count in the peripheral vein blood and the manifestations of CXR (chest X-ray). Conclusions SARS is a totally new and severe contagious disease, caused by Coronavirus. Lung is the right main target organ attacked by this virus. Fever and the respiratory symptoms were the most common clinical presentations. All respiratory symptoms were appeared most commonly at the first pyretic day and at the first day during the course of SARS, and they were appeared second commonly at the 8th pyretic day and at the 8th day during the course of SARS. And cough was the most common respiratory symptom, followed by dyspnea and expectoration; and the least respiratory symptom was expectoration with blood streak sputum. At the moment, there was no golden standard for SARS diagnosis; and there were no effective ways to control Coronavirus either. Epidemiological and clinical characters were the main information used for early diagnosis of SARS.