SARS与其他病毒性肺炎发病不同时期血液生化指标变化特点的比较

目的　通过比较分析严重急性呼吸综合征 (SARS)与其他病毒性肺炎患者血清中各项生化指标的变化特点 ,探讨 SARS发病机制。方法　采用 Roche诊断公司的试剂盒和日立 76 0 0全自动生化分析仪 ,检测 SARS患者和 4 0例其他病毒性肺炎患者发病急性期及恢复后血液中总蛋白 (TP)、血清白蛋白 (Alb)、总胆固醇 (TC)、甘油三酯 (TG)、钙 (Ca)、铁 (Fe)、乳酸脱氢酶 (L DH)、肌酸激酶 (CK)、丙氨酸转氨酶 (AL T)和天冬氨酸转氨酶 (AST)的变化 ,并将 4 0例健康体检者的血指标作为正常对照 ,比较两种病毒性肺炎患者上述各指标的变化和差异。结果　与正常人比较 ,SARS患者急性期血液中 TC、Fe、Ca、Alb明显降低 (P<0 .0 5或P<0 .0 1) ,而血清 L DH、CK、AL T和 AST活性则均升高 ,以 CK的增高和 Fe的下降最为明显 (P<0 .0 5或P<0 .0 1) ;TP和 TG变化不明显。其他病毒性肺炎组 AL T、AST、L DH较正常人稍增高 ,Fe、Ca、Alb、TC、CK稍降低 ,但均无统计学意义 ,TP、TG变化不大。SARS患者恢复期除 AL T、AST仍高于正常 (P均 >0 .0 5 )外 ,其余各指标均恢复到正常范围内。结论　 SARS患者急性期上述血液生化指标的异常变化与其他病毒性肺炎患者相比 ,变化幅度更大 ,大剂量抗病毒药引起 Fe下降和肝脏损害造成 TC合成障碍有重

Comparison of serum biochemical features between SARS and other viral pneumonias

Objective To identify blood chemistry changes in coronavirus of severe acute respiratory syndrome(SARS). Methods Biochemical changes in SARS patients were summarized and compared with other viral pneumonias. Serum total protein(TP), albumin(Alb), total cholesterol(TC), triglyceride(TG), calcium(Ca), ferrum (Fe), lactate dehydrogenase (LDH), creatine kinase (CK), alanine aminotransferase(ALT) and aspartate aminotransferase(AST) between SARS and other viral pneumonias were examined by Roche Diagnostics assay, HITACHI7600 automatic analyzer. Clinically confirmed SARS patients, patients with other viral pneumonias, and healthy controls were included in the study. Results Compared with healthy person, the levels of serum TC, Fe, Ca, Alb were significantly lowered( P <0 05 or P <0 01), while the activity of LDH, CK, ALT, AST were elevated, the increase of CK and the decrease of Fe were the most significant( P <0 05 or P <0 01), the changes of TP and TG were not obvious. In the other viral pneumonias patients, ALT, AST, LDH were elevated slightly than those of healthy person, while Fe, Ca, Alb, TC, CK were a little reduced, but there was no significant difference between the two groups. In convalescent stage, all the tests were returned to normal ranges except ALT, AST were still elevated in SARS patients. Conclusion The changes in serum biochemistry are more marked in SARS patients compared with patients suffering from other viral pneumonias, the decrease of Fe as well as the inhibition of TC may be caused by the treatment of antivirus.