35例SARS患者临床特征分析

目的 :探讨严重急性呼吸综合征 (SARS)的临床特征。方法 :回顾分析过去 5个月里我院收治的 35例SARS患者的临床特征 ,并与普通的社区获得性肺炎患者进行比较。同时用流式细胞仪检测了 13例 SARS患者和 10例健康志愿者的外周血 CD+ 4和 CD+ 8T淋巴细胞。结果 :SARS最常见的表现为发热 (10 0 .0 0 % )、咳嗽(74 .30 % )、头痛 (4 5 .70 % )、全身肌肉酸痛 (4 5 .70 % )及淋巴细胞减少 (2 0 /33)。 X线胸片表现为进行性发展的多发性肺浸润病灶。 13例 SARS患者外周血 CD+ 4和 CD+ 8明显降低〔 CD+ 4为 (16 .10± 4 .31) %比 (38.30±8.5 2 ) % ,CD+ 8为 (19.90± 5 .4 0 ) %比 (2 8.38± 4 .33) % ;t值分别为 8.174和 4 .0 5 5 ,P均 <0 .0 1〕,SARS组患者平均退热时间较肺炎组长〔(13.92± 8.35 ) d比 (3.86± 1.4 2 ) d,t=16 .4 90 ,P=0 .0 0 0〕;肺总病变吸收时间也明显延长〔(11.97± 4 .4 1) d比 (9.2 1± 4 .4 2 ) d,t=3.0 82 ,P=0 .0 0 3〕。结论 :SARS患者主要表现为发热、咳嗽、头痛、全身肌肉酸痛 ,外周血淋巴细胞计数减少 ,CD+ 4和 CD+ 8细胞明显降低 ,肺内多发性浸润病灶。

Retrospective analysis on clinical features of 35 patients with severe acute respiratory syndrome

OBJECTIVE: To analyze the clinical features of severe acute respiratory syndrome (SARS). METHODS: The clinical features of 35 patients with SARS in the past five months were retrospectively studied, and compared with 35 patients with community-acquired pneumonia. Consecutive blood samples from 13 patients with SARS and 10 healthy volunteers were collected. The CD+4 and CD+8 in T cell in peripheral blood were detected by flow cytometry. RESULTS: The most common symptoms included fever (in 100.0 percent of the patients), cough (74.3 percent), headache (45.7 percent), myalgia (45.7 percent) and lymphopenia (20/33). Serial chest radiographs showed progressive multi-infiltration in the lung fields. The CD+4 and CD+8 in T cell in 13 patients with SARS significantly decreased [CD+4: (16.10+/-4.31) percent vs. (38.30+/-8.52) percent, t=8.174,P<0.01; CD+8: (19.90+/-5.40) percent vs. (28.38+/-4.33) percent, t=4.055, P<0.01]. The time of bringing down the fever and the time of absorption of pathological changes in SARS patients were prolonged than those of the pneumonia patients [the time of bringing down the fever (13.92+/-8.35) days vs. (3.86+/-1.42)days, t=16.490,P=0.000;the time of absorption of pathological changes: (11.97+/-4.41) days vs. (9.21+/-4.42) days, t=3.082,P=0.003]. CONCLUSION: SARS is a serious respiratory illness, the most common symptoms are fever, cough, headache and myalgia, other common findings are lymphopenia, the CD+4 and CD+8 in T cell in peripheral blood decrease and multi-infiltrate through out the lung fields.