广州地区严重急性呼吸道综合征的临床特点  

Clinical characteristics of the severe acute respiratory syndrome in Guangzhou

作　　者：彭劼[1] 侯金林[1] 郭亚兵[1] 冯筱榕[1] 陈金军[1] 刘定立[1] 朱幼芙[1] 姜荣龙[1] 陈永鹏[1] 

机构地区：[1]第一军医大学南方医院感染内科,广州510515

出　　处：《中华传染病杂志》2003年第2期89-92,共4页Chinese Journal of Infectious Diseases

基　　金：国家杰出青年科学基金资助项目 ( 30 2 2 5 0 42 )

摘　　要：目的　探讨当前流行的严重急性呼吸道综合征 (SARS)的若干临床特点。方法　回顾性统计分析广州南方医院收治的 85例SARS患者的临床资料。结果　 85例SARS患者的年龄在 4～ 87岁 ,平均 ( 38.2± 16 .7)岁 ,男 41例 ,女 44例。该病的潜伏期为 2～ 16d ,平均为 ( 7.4± 3 .8)d ;主要临床表现有发热 ( 97.6 %)、咳嗽 ( 81.2 %)、乏力 ( 74.1%)、头痛 ( 6 3 .5 %)、肌肉酸痛 ( 41.2 %) ;热程多为 4～ 12d( 81.9%) ,平均热程为 ( 7.8± 3.5 )d ;外周血白细胞计数正常或降低 ( 82 .4%) ,淋巴细胞计数减少 ( 2 7.1%) ;血液生化示丙氨酸转氨酶升高 ( 44 .7%) ,天门冬氨酸转氨酶升高 ( 5 7.6 %) ,乳酸脱氢酶升高 ( 49.4%) ,肌酸磷酸激酶升高 ( 2 0 %) ;肺部X线摄片主要表现为片状或斑片状炎症渗出( 85 .9%) ,少数表现为间质性炎症改变 ( 14.1%) ;炎症多位于双侧下肺 /中下肺 ( 5 1.8%) ,其次为单侧下肺 /中下肺 ( 36 .5 %) ;发病至肺炎症渗出完全吸收的平均时间为 ( 2 0 .3± 8.4)d ,热退后至肺炎症渗出完全吸收的平均时间为 ( 13 .1± 6 .9)d ;经验性治疗为 :病毒唑、对症支持治疗及应用广谱抗生素。结论　SARS具有传染性 ,发热、咳嗽、胸片示肺部炎症表现及外周血白细胞正常或降低是该综合征的临床特点。Objective To explore the information on the clinical features of the severe acute respiratory syndrome (SARS) prevalent recently. Methods We collected and analyzed clinical date from the 85 inpatients suffered from SARS in Nanfang Hospital, Guangzhou. Results The patients ranged from 4 to 87 years old (mean age 38.2±16.7 years). The incubation period ranged form 2 to 16 days (mean periods 7.4± 3.8 days). The most common symptoms included fever (in 97.8 percent of the patients), cough (81.2%), malaise (74.1%), headache (63.5%), myalgia (41.2%). Peripheral vein blood test showed normal leukocytes and leukopenia in 82.4 percent of the patients. Other common findings were lymphopenia (in 27.1 percent of the patients), elevated alanine aminotransferase (44.7%), elevated aspartate aminotransferase (57.6%), elevated lactase dehydrogenase (49.4%) and elevated creatinine kinase (20.0%). Chest radiographs predominately showed air-space shadowing, such as ground-glass opacities, focal consolidation or patchy consolidation. The air-space shadowing was mostly in the lower lung zones (in 88.3 percent of the patients, bilateral and unilateral for 51.8% and 36.5% respectively). The mean period of complete resolution of the air-space shadowing was 20.3±8.4 days and 13.1±6.9 days after onset of illness and absent fever respectively. Empirical therapy most commonly included ribavirin, antibiotics. Conclusions SARS appears to be infectious. Fever followed by rapidly progressive respiratory compromise is the key complex of signs and symptoms from which the syndrome derives its name.

关 键 词：广州地区 急性呼吸道综合征 临床特点 非典型性肺炎 发热 咳嗽 乏力 头痛 

分 类 号：R511.9[医药卫生—内科学]