83例SARS病人并发其他脏器损害的临床特点

The Clinical Features of Other Organs Injury in 83 Patients with Severe Respiratory Syndrome (SARS)

目的 探讨重症急性呼吸综合征 (SARS)并发其他脏器损害的临床特点 ,并分析可能引起的原因。方法 收集 2 0 0 3年 3月 11日～2 0 0 3年 5月 15日在北京佑安医院收治的SARS病人 83例 ,观察流行病学史、临床表现、进行肝功能、肾功能、心肌酶、血糖等的检测。结果 在肝损害方面 ,第 1周有 18 9%的病人ALT (谷丙转氨酶 )升高 ,14 9%的病人AST (谷草转氨酶 )升高 ,有少部分病人出现黄疸 ;在第 2周、第 3周SARS病人的肝损害明显上升 ,其中以ALT单项增高为主 (分别为 5 0 7%和 6 7 2 % )。同时有近 5 0 0 %的病人出现白蛋白降低 ,第 1周有显著差异。至第4周及第 5周开始逐渐恢复正常 ,但有个别SARS病人恢复后 ,肝功能仍不正常 ,在心肌损害方面 ,主要以心肌酶升高为主 ,以第 1周及恢复期 (第 4周及第 5周 )升高明显 ,而在急性期升高不明显 (P <0 0 5 )。肾损害方面只出现在第1周 ,以尿素氮 (BUN)升高为主。在胰腺损害方面 ,表现为血糖升高 ,而无明显的症状。结论 SARS病毒不仅引起肺脏的损伤 。

Objective To summarize the clinical features of other organs injury in patients with severe respiratory syndrome (SARS) and analyze the possible causes by SARS and provide information for further mechanism of SARS and provide evidence in order to raise healing rate and to decrease fatal rate.Methods We collected and analyzed the epidemiology. Clinical situation sign hepatic function, renal function, myocardium enzyme, blood sugar of 83 patients suffered from SARS were admitted to the isolation ward of You'an Hospital of Beijing from March 11 to June 2003.Results Serum ALT levels were elevated in 18.92% in SARS patients and serum AST levels were stepped-up in SARS patients in the first week, and jaundice occurred in some SARS patients, but serum ALT and AST levels were elevated more quickly in the second and third week than the first week, especially ALT. And at the same time serum albumin levels were decreased in 50% in SARS patients. Most of them turned gradually normal in the fourth or fifth week, but few SARS patients have not recovery. As myocardium lesion, myocardial enzymes elevated at the first week and recovery period but not in acute phase (P<0.05). Kidney lesion occurred during the first week with BUN elevated mainly. In pancreas lesion, blood sugar was elevated without obvious symptom.Conclusion SARS not only injury lung, but also damage multi-organs.