SARS临床流行病学分析

The Epidemic Analysis of SARS' Clinic

目的探讨SARS的临床流行病学特点。方法回顾性收集并登记122例SARS患者的流行病学和临床资料及其动态变化,建立数据库后进行分析。结果本组病例以青壮年为主,42例(34.4%)有明确的SARS患者接触史,其中以医院和家庭接触为主。入院时的主要症状为发热(116例,95.1%)、寒颤(37例,30.3%)、咳嗽(90例,73.8%)、咳痰(78例,63.9%)、全身酸痛(33例,27%)和呼吸困难(14例,11.5%)。入院时外周血白细胞计数正常者有81例(66.4%),低于正常上限者35例(28.7%),高于正常上限者6例,其中61例(50%)的淋巴细胞计数下降,在住院过程中,共有34例(27.9%)的白细胞总数高于正常上限(>10000/mm3);入院时91例(74.6%)胸片病灶为云雾状,76例(62.3%)有致密阴影,7例有肺实变,所有病例无胸腔积液、气胸或纵隔气肿,82.8%的病例于入院后平均(9.17±5.05)d病灶开始吸收;47例应用过糖皮质激素;34人接受无创通气,8例接受有创通气;32例次出现肝、肾、心功能损害、消化道出血和继发细菌和真菌感染等并发症,6例死亡。结论SARS主要表现为发热、寒颤、咳嗽、咳痰、全身酸痛和呼吸困难,易出现低氧血症和多脏器功能损害,影像学无明显特异性。

Objective To analyze the character of the epidemiology of SARS’clinic. Method By collecting and registering the epidemiology and clinic data of 122 cases, a related database was established and analyzed. Result The major of the cases were the youth or the midlife, 34.4%of which had accessed to the SARS patient, especially in hospital or house. The main symptoms of checked date were fever( 116 cases or 95.1%),chill(37 cases or 30.3%),cough(90 cases or 73.8%),cough with phlegm(78 cases or 63.9%),ache of the whole body(33 cases or 27.0%)and dyspnoea(14 cases or 11.5%). The hemanalysis of leucocyte displayed that 66.4%of the cases is normal, 27.9%were below the range and 4.9%were above. The lymphocyte analyses displayed that 50%of the patients is below the normal range. During hospital,29%of the cases had got a number of leucocyte above the range( >10 000/mm3). The chest focus by X ray showed that 74.6%were cloudy, 62.3%were tight, 5.7%had a hard focus and 82.8%of the cases had got a absorbed focus on (9.17±5.05) days after the checked day. Some accompanying symptoms were discovered on 32 cases, including in functional defeat of liver, kidnap and heart, enteron hemorrhage and bacteria infection of or epiphyte infection so on, within which 6 cases were dead. Conclusion The SARS' clinic was mainly included fever, chill, cough (with or without phlegm), body’s ache, dyspnoea, the functional defeat of multi viscera and unclear display in X ray.