PCR确诊SARS患者四例

Four cases of SARS confirmed by PCR

目的了解SARS的临床及流行病学特点。方法对经PCR检测阳性而确诊的4例SARS经随访后进行回顾性分析。这些病人早期都未用激素治疗。结果发热均为首发症状,最高温度≥38℃。均无头痛、咽痛,咽部均无明显充血,扁桃体均不大。疾病早期淋巴细胞计数不低。肝功异常较多(3/4),与病情轻重不相关。肾功能均正常。CRP升高。未用激素,2例热程分别为4 d和6 d。1例出现双峰热,LYM进行性下降,最后死亡。1例在持续高热15 d后给少量激素,20 h后体温降至正常。3例发病3 d内住院隔离治疗未传染他人。结论(1)SARS的早期临床症状与流感不同。(2)LYM进行性降低是病情恶化的标志。(3)潜伏期及发病早期可能无传染性。(4)选择性使用激素。

Objective To elucidate the clinical and epidemical characteristics of SARS. Methods Four SARS cases confirmed by laboratory tests were analyzed retrospectively by following up studying. All the patients didn＇t receive corticosteroid therapy at early stage. Results The first symptom was fever, the tiptop temperature ≥38℃. There were no headache, sore throat. Pharynx was not congested and the tonsils were not enlarged. Lymphocyte counts were not low at early stages of SARS. Liver damage was present in most of the patients, which have no relationship with the degree of illness. Renal function was normal in all cases. CRP was abnormally rising. Fever remained 4 and 6 days in 2 patients receiving no corticosteroid therapy. One patient had double-phase fever with progressively decrease of LYM died. Temperature dropped to normal 20 hours after corticosteroid therapy （160mg/d） in a patient with 15 days lasting fever. Three patients isolated within 3 days of onset of symptom did not transmitted SARS to others. Conclusion The clinical symptoms of SARS are distinguishable from influenza at early stage. Decreasing of LYM indicates the deterioration of SARS development. It seems no infectivity during the incubation period and early stage of the disease. Corticosteroid therapy should be selectively used.