61例严重急性呼吸综合征临床分析

回顾性分析确诊的 61例严重急性呼吸综合征 (SARS)患者。发现 :发病 2周为疾病的高峰期。有明确SARS接触史者 47人 ( 77.1 % )。 5 6例 ( 91 .8% )静点甲泼尼龙 ,5 4例 ( 88.5 % )使用利巴韦林治疗。用药后血红蛋白降低幅度达 2 0 g/L者占 44.4% ( 2 4/ 5 4) ,心动过速者占 40 .4% ( 2 3 / 5 7)。 6例死亡患者中 5例为老年人 ,均合并严重的基础病变 ,另 1位患者在住院期间自杀。所有患者在出现症状后 ( 8.6± 5 .9)d( 1～ 2 4d)胸片显示异常 ,胸片浸润性病灶完全吸收的平均时间为 ( 1 7.1± 6.2 )d( 5～ 3 5d)。提示 :对SARS患者 ,早期、持续一定时间的中等剂量的激素是必要的 ;治疗过程中应该重视大量激素和大量利巴韦林带来的不良反应。

Clinical Analysis of 61 Patients with SARS

Altogether 61 patients with SARS were analyzed retrospectively.Of the 61 patients, 47(77.1%) were certainly exposed to SARS. Two weeks after falling ill was considered to be the most serious period of SARS. 54 patients (88.5%) were treated with ribavirin and 56(91.8%) with hylprednisone, although its use was associated with significant toxicity,including decrease in hemoglobin of 20 g/L(24/54,44.4%). Tachycardia (>100 beat/min) happened in 23/57(40.4%) cases. 6 patients died, in which 5 patients were aged and all of them were complicated with serious systemic diseases. The other one committed suicide in hospital. The first positive chest radiograph was diagnosed (8.6±5.9) d(1～24 d), just after the symptoms manifested. The abnormal chest radiograph recovered to normal in (17.1±6.2) d(5～35 d). The glucocorticoid is administered early is necessary for the SARS patients. The results show that more attention should be paid to the side effects resulted from excessive dosage of hormone and ribavirin.