重症SARS患者临床特点分析

为观察和分析重症严重急性呼吸综合征(severeacuterespiratorysyndrome,SARS)患者的临床特点及其影响因素,对我院收治的149例重症SARS患者进行回顾性分析,分别观察患者的一般情况、临床表现、化验指标、肺部阴影、心电图变化、各种治疗情况及预后。结果149例重症SRAS患者中男女比例相当,年龄多于25～75岁之间,40.3%合并慢性基础病,96.0%患者发热,58.0%外周血白细胞正常或降低,78.7%淋巴细胞减少,60%以上血生化多种酶升高,46.9%白蛋白/球蛋白(A/G)比值降低,37.6%血糖(GLU)升高,53.1%患者有低氧血症,81.8%肺损伤面积大,31.7%有心电图异常,58.7%有并发症。主要治疗包括糖皮质激素、抗生素、抗真菌药、抗病毒药、免疫增强剂、中药、吸氧和呼吸机辅助呼吸及支持疗法。最终痊愈和好转患者130人(占87.2%),死亡19人(12.8%)。提示高龄、合并基础疾病和并发症、肺损伤面积大、低氧血症严重、血生化改变大的患者病情重、病死率高。

Clinical Features in SARS Patients in Severe Conditions

The objective was to observe and analyze the clinical features and related factors in SARS(severe acute respiratory syndrome)patients in severe condition.Methods:Clinical data of149patients with probable SARS in severe condition admitted in Xuanwu Hospital were analyzed retrospectively,including general appearance,clinical manifestations,laboratory findings,radiological findings,ECG,treatment and outcome respectively.Result:In149SARS patients in severe condition aged from25to75,the following were symploms:accompanied chronic diseases(40.3%),fever(96.0%),normal or decreased blood white cell count(58.0%),lymphopenia(78.7%),increased serum enzymes(60%),decreased albumin/globulin ratio(46.9%),increased glucose(37.6%),hypooxygenemia(53.1%),larger lung tissue damage site(81.8%),ECG abnormality(31.7%),complications(58.7%).Treatment included corticosteriods,antifungals,antibacterials and antivirals,immunopotentiator,traditional Chinese medicine,oxygen supply and mechanically supported respiration.The final recovery(87.2%)and mortality(12.8%)were found in these patients.Conclusion:Senility,underlying diseases,complications and larger lung tissue damag,severe abnormality in serum enzyme examination contribute to severe condition and higher mortality in SARS patient.