SARS死亡病例的实验室检查特点

Analysis of the clinical features of 5 dead cases of severs acute respiratory syndrome

目的 :了解严重急性呼吸综合征 (SARS)死亡病例的临床特点 ,为SARS重症病例的诊断、治疗及预后判断提供帮助。方法 :对我院 2 0 0 3年 1月至 4月底收治的 10 2例确诊非典患者中的 5例死亡病例的流行病学及实验室检查资料进行回顾性分析。结果 :死亡病例均为男性 ,平均 4 9岁 ,从发病到入院平均 7.6d ,从住院到确诊平均 1.2d ;从住院到死亡平均 14 .4d ,从发病到死亡平均为 2 2d。死亡病例粒细胞总数和百分比均明显升高 ,多数患者淋巴细胞计数和百分比降低 (4 /5 ) ,血红蛋白均呈进行性下降。死亡患者除已见报道的ALT、AST、LDH、CK升高及低钙血症外 ,GLU均明显高于正常而ALB均明显降低 ;大多数患者TP、PA等多项生化指标均出现明显下降而脱氧血红蛋白百分率 (HHb)明显上升 ,同时伴有低磷、低镁血症。结论 :SARS死亡病例多项实验室指标均会出现明显异常 ,动态监测这些指标有助于SARS患者的诊断、治疗及预后判断。

Objective:To investigate the clinical features of the dead cases of severe acute respiratory syndrome (SARS) in order to give some advices to the diagnosis, treatment and prognosis of SARS. Methods:Data of epidemiology and laboratory examination of 5 dead SARS patients hospitalized from January to late April this year were retrospective analyzed. Results:The dead cases were all male, with average age of 49. There were average 9.6 days from disease incidence to hospitalization, 1.2days from hospitalization to identification, 14.4days from hospitalization to death, 22days from disease incidence to death. The total amount and percentage of the granulocytes increased greatly in all the 5 patients . The count and percentage of lymphocytes decreased, along with the hemoglobin decreasing in most of the patients. All the dead cases had higher glucose and lower albumin, except for ALT, AST, LDH, CK increasing and calcium decreasing , which were already reported. In most cases, multiple biochemistry items dropped significantly ,such as TP, PA, etc, while the HHb increased greatly, accompanied with low P and Mg. Conclusion:Multiple items of laboratory examination will alter greatly in SARS patients. Constantly monitor of these items may benefit the diagnosis, treatment and prognosis of this disease.