2004年中国4例散发SARS病例的实验室研究

目的探讨2004年中国广州4例散发严重急性呼吸综合征(SARS)病例实验室检查的特点。方法分析2004年确诊的4例散发SARS病例的实验室检查结果，并与流行时的情况相比较。结果确诊的SARS患者白细胞及淋巴细胞呈不同程度降低，下降时间较流行时提前，下降程度较小；2例外周血T细胞亚群计数轻微降低；3例丙氨酸转氨酶(ALT)和天冬氮酸转氮酶(AST)轻度升高；肾功能、血糖、血脂及心肌酶均无异常；所有患者血清SARS—IgM／IgG抗体早在发病第6d由阴转阳，滴度在短期内呈4倍以上升高，中和抗体实验阳性，1例咽拭子中检测出SARS冠状病毒(SARS—CoV)RNA。结论2004年中国广州4例散发SARS病例临床表现较轻，病程短，无并发症；各常规实验室检查与生化检查变化均较流行时为轻，归因于此次致病的SARS—CoV毒力小，抗体出现较早，病毒迅速被清除。

Study of laboratory characteristic of 4 patients with sporadic severe acute respiratory syndrome in 2004

Objective To analyze the laboratory characteristics of patients with sporadic severe acute respiratory syndrome (SARS) in China. Methods The laboratory findings of the 4 cases with SARS occurringin Guangzhou, People's Republic of China, in 2004 were analysed and compared with that during epidemic. Results Leucocytopenia and lymphocytopenia were seen in all the patients. Two patients had slightly decreased peripheral blood T lymphocyte count. Alanine aminotransferase(ALT) and aspartate transaminase(AST) levels increased slightly in 3 patients. No hypoxemia was seen in all the patients. Both SARSIgM and IgG seroconversion occurred earlier in all the patients with the titer increased more than 4foldshortly. Neutralization test was positive in all the patients. SARS coronary virus (SARSCoV)RNA was detected by polymerase chain reaction (PCR) in pharyageal swabs only in 1 patient. Conclusion The 4 sporadicSARS patients in 2004 have milder manifestations, shorter course of disease with no complicationsduring an epidemic, compared with patients seen previously. The change in laboratory findings is less than that, which might be attributable to milder virulence of the SARSCoV. The antibody appears earlier in these patients. The SARSCoV is eliminated rapidly.