抗生素在严重急性呼吸综合征诊断中作用的探讨

目的探讨抗生素在严重急性呼吸综合征(SARS)诊断中的作用。方法对太原市定点医院的304例住院确诊SARS病例住院前临床症状及抗生素的使用情况进行分析、评价。结果304例SARS患者主要的临床症状有发热298例,占98.0%;咳嗽161例,占53.0%;乏力156例,占51.3%;全身肌肉酸痛95例,占31.3%;咯痰84例,占27.6%;畏寒85例,占27.3%;少数有头痛、咽痛、关节痛、呼吸困难、恶心呕吐、腹痛及腹泻等。77%的SARS患者在入院前使用了抗生素,其中98%治疗效果为无效、差或一般。123例有明确的流行病学接触史,占40.5%。早期白细胞正常或下降的SARS患者有213例,占93.4%。结论SARS患者临床症状以全身症状(如发热、寒战、乏力、肌痛及畏寒)和呼吸道症状(如咳嗽、气促及呼吸困难)为主;多数有明确的流行病学接触史及抗生素治疗史,而且抗生素治疗无效为特征。

Study on the diagnostic value of antibiotics in severe acute respiratory syndrome

Objective To study the diagnostic value of antibiotics in severe acute respiratory syndrome (SARS).Methods Three hundred and four hospitalized SARS patients in Taiyuan′s appointed hospitals were surveyed as to their prethospitalized symptoms and antibiotic use,the data submitting to analysis and evaluation.Results Among the 304 cases,clinical symptoms were fever in 298 (98%),cough in 161 (53%),fatigue in 156 (51.3%),muscle pain in 95 (31.3%),expectoration in 84 (53%),aversion to cold in 85 (27.3%);a few cases with headache,throat sore,arthralgia,dyspnea,nausea and vomiting,abdominal pain,and diarrhea etc.77% of SARS patients had used antibiotics before entering hospital,the therapeutic effect on 98% of cases was bad or little.One hundred and twenty-three patients (40.5%) had definitly epidemic disease contact history Two hundred and thirteen patients (93.4%) had decreased or normal WBC in the beginning.Conclusion SARS patients have the systemic symptoms (fever,fatigue,thrill,muscle pain and aversion to cold) and respiratory symptoms (cough and dyspnea) as the main symptom.Most of them have definitely epidemic disease contact history and antibiotic-treating history with no significant effects.