北京地区40例严重急性呼吸综合征的临床探讨

目的　了解严重急性呼吸综合征 (SARS)的临床特点 ,积累临床诊治经验。方法　收集我院及我院医务人员在酒仙桥医院收治的 4 0例SARS患者和 2 0例疑似后排除SARS的病例资料进行回顾性调查。结果　 4 0例确诊SARS中 30例 (75 .0 % )有明确接触史 ,其中 17例 (4 2 .5 % )为家庭内传染 ,12例 (30 .0 % )为医院内传染 ,而排除组 2 0例均无明确接触史。 4 0例确诊SARS患者均出现发热 ,部分伴咳嗽 ,咳痰 ,腹泻 ,肌肉酸痛 ,头痛 ,白细胞、淋巴细胞、血小板减低 ,转氨酶增高 ,白蛋白减低 ,球蛋白增高 ,血气分析提示血氧分压 (PaO2 ) <90mmHg(1mmHg =0 .133kPa)共 31例 (77.5 % ) ,血氧饱和度 (SaO2 ) <97%共 37例 (92 .5 % ) ,胸片提示单肺病变 2 0例 (5 0 .0 % ) ,双肺病变 2 0例 (5 0 .0 % ) ,14例 (35 .0 % )给予 1种抗生素治疗 ,而 2 6例 (6 5 .0 % )给予 2种抗生素治疗 ,33例 (82 .5 % )给予利巴韦林抗病毒治疗 ,2 3例 (5 7.5 % )给予糖皮质激素治疗 ,3例 (7.5 % )需呼吸机辅助呼吸 ,确诊SARS病例 1例死亡 ,排除组 2 0例均好转。经两组间比较 ,流行病学史、血氧分压、血氧饱和度、胸部X线片改变均有统计学意义 (P <0 .0 5 )。其他如临床症状、血常规、血沉、生化指标等均无统计学意义 (P >0 .0 5 )。结论　S

Clinical characters of severe acute respiratory syndrome in Beijing

Objective To study clinical characters of severe acute respiratory syndrome(SARS),and provide the experience of diagnosis and treatment in SARS.Methods Retrospective survey was performed on 40 cases confirmed of SARS and 20 cases of suspicious controls.Results Of the 40 patients confirmed of SARS,30 cases ( 75.0% ) had obvious contact history,17 cases( 42.5% ) in household and 12 cases( 30.0% ) in hospital,while the suspicious 20 cases had no contact history.Clinical features of the SARS ones were fever(100%),cough,sputum,diarrhea,myalgia,headache,leukopenia,lymphopenia,thrombocytopenia,increased aminotransferase,hypoalbumin and hyperglobulin.Blood gas analysis showed PaO 2<90 mm Hg in 31 cases ( 77.5% ) and SaO 2<97% in 37 cases ( 92.5% ).Chest radiograph showed unilateral focus in 20 cases ( 50.% ) and bilateral focus in 20 cases ( 50.0% ).14 patients ( 35.0% ) were administered one kind of antibiotic while 26 patients ( 65.0% ) were adminiserted two kinds.33 patients ( 82.5% ) received ribavirin.23 patients ( 57.5% ) were given corticosteroid.3 patients ( 7.5% ) required BiPAP assisted ventilation.One SARS patient died.There was significant difference in frequencies of epidemiology,pressure of blood oxygen,oxygen saturation of blood,X ray of chest.Conclusion SARS is a contagious disease,such as spreading in household and health care settings.Epidemiology,pressure of blood oxygen,oxygen saturation of blood,X ray of chest were most important in diagnosis.