SARS患者的体温变化规律及临床对照研究  

Temperature changes of patients with severe acute respiratory syndrome: a comparative study

作　　者：陈平雁[1] 刘理[2] 刘定立[3] 莫一心[1] 张超[1] 欧春泉[1] 王淑平[1] 杨海青[1] 安胜利[1] 

机构地区：[1]南方医科大学卫生统计学教研室,广东广州510515 [2]南方医科大学临床管理处,广东广州510515 [3]南方医科大学南方医院感染内科,广东广州510515

出　　处：《第一军医大学学报》2005年第9期1095-1099,共5页Journal of First Military Medical University

基　　金：广州市科委科技攻关项目(2003Z1-E0117)~~

摘　　要：目的探讨SARS病人住院后的体温变化规律,探讨糖皮质激素类药物治疗对SARS患者体温的影响.方法测定94例SARS[分为激素治疗组(35例)和非激素组(59例)]和200例其他疾病[间质性肺炎(65例)、普通肺炎(78例)、上呼吸道感染(57例)]的体温,并观察激素治疗对SARS患者体温的影响.结果 4种疾病患者的平均体温均在住院后7日内有明显的下降患者(P＜0.001),7日后平均体温波动较小,且基本在正常体温范围.SARS患者的体温在各个时间点均高于其他疾病(P＜0.03),幅度在0.2～0.5℃之间.SARS体温的变化趋势与其他疾病相近(P=0.271).在每日4个测体温时间,即6、10、14、18时,以14时的体温最高,显著高于其他3个时刻(P＜0.001).激素治疗前,SARS患者两亚组体温无显著差异(P=0.482),治疗后亦无显著差异(P=0.180).SARS患者住院后的热程为(3.01±4.05)d、间质性肺炎患者为(1.68±3.19)d、普通肺炎为(2.09±2.40)d、上呼吸道感染者为(1.27±1.48)d.热程的整体检验有显著差异,SARS的热程最长.结论住院后7 d内,4种疾病患者每日体温以14时最高;SARS患者的体温显著高于其它疾病;SARS患者是否接受激素类药物治疗对体温影响不显著;SARS住院后的热程最长.Objective To explore the patterns of temperature changes of patients with the severe acute respiratory syndrome （SARS） and the effect of glucocorticoid hormone on the temperature of these patients. Methods The clinical data of 94 SARS cases treated during the outbreak of SARS in South China in 2003 were collected for a retrospective review. According to different treatment regimens, the patients were divided into hormone group （n=35） and non-hormone group （n=59）. The control groups consisted of 65 patients with interstitial pneumonia, 78 with bacterial pneumonia and 57 with upper respiratory tract infection. The changes in body temperature were compared between the SARS patients and those with other respiratory diseases and the effect of glucocorticoid hormone on controlling body temperature of the SARS patients was explored. Results The body temperature of patients with the 4 diseases all exhibited obvious reduction 7 days after hospitalization （P〈0.001） with only subsequent mild fluctuation within the basically normal range. At each time point of measurement, the body temperature of SARS patients was significantly higher than that of patients with other diseases （P〈0.03）, with a fluctuation of 0.2 to 0.5 ℃ and following a pattern of variation similar to those of the other diseases. Of the 4 time points of daily measurement, namely 6, 10, 14 and 18 o＇clock, the temperature measured at 14 o＇clock was significantly higher than those at the other 3 time points （P〈0.001）. Hormone therapy did not significantly affect the temperature of SARS patients （P=0.180）, who had longer duration of high fever. Conclusion SARS patients have higher body temperature and longer duration of high fever. Hormone therapy may not produce significant effect in controlling the temperature of SARS patients.

关 键 词：SARS/药物治疗 体温 回顾性研究 

分 类 号：R511.9[医药卫生—内科学]