35例SARS患者临床特征分析

Retrospective analysis on clinical features of 35 patients with severe acute respiratory syndrome

目的 :探讨严重急性呼吸综合征 (SARS)的临床特征。方法 :回顾分析过去 5个月里我院收治的 35例SARS患者的临床特征 ,并与普通的社区获得性肺炎患者进行比较。同时用流式细胞仪检测了 13例 SARS患者和 10例健康志愿者的外周血 CD+ 4和 CD+ 8T淋巴细胞。结果 :SARS最常见的表现为发热 (10 0 .0 0 % )、咳嗽(74 .30 % )、头痛 (4 5 .70 % )、全身肌肉酸痛 (4 5 .70 % )及淋巴细胞减少 (2 0 /33)。 X线胸片表现为进行性发展的多发性肺浸润病灶。 13例 SARS患者外周血 CD+ 4和 CD+ 8明显降低〔 CD+ 4为 (16 .10± 4 .31) %比 (38.30±8.5 2 ) % ,CD+ 8为 (19.90± 5 .4 0 ) %比 (2 8.38± 4 .33) % ;t值分别为 8.174和 4 .0 5 5 ,P均 <0 .0 1〕,SARS组患者平均退热时间较肺炎组长〔(13.92± 8.35 ) d比 (3.86± 1.4 2 ) d,t=16 .4 90 ,P=0 .0 0 0〕;肺总病变吸收时间也明显延长〔(11.97± 4 .4 1) d比 (9.2 1± 4 .4 2 ) d,t=3.0 82 ,P=0 .0 0 3〕。结论 :SARS患者主要表现为发热、咳嗽、头痛、全身肌肉酸痛 ,外周血淋巴细胞计数减少 ,CD+ 4和 CD+ 8细胞明显降低 ,肺内多发性浸润病灶。

Objective: To analyze the clinical features of severe acute respiratory syndrome(SARS). Methods : The clinical features of 35 patients with SARS in the past five months were retrospectively studied, and compared with 35 patients with communityacquired pneumonia. Consecutive blood samples from 13 patients with SARS and 10 healthy volunteers were collected. The CD + 4 and CD + 8 in T cell in peripheral blood were detected by flow cytometry. Results: The most common symptoms included fever(in 100 0 percent of the patients), cough (74 3 percent), headache (45 7 percent), myalgia (45 7 percent) and lymphopenia (20/33) . Serial chest radiographs showed progressive multiinfiltration in the lung fields. The CD + 4 and CD + 8 in T cell in 13 patients with SARS significantly decreased〔CD + 4:(16 10±4 31) percent vs. (38 30±8 52) percent, t =8 174, P <0 01; CD + 8: (19 90±5 40) percent vs. (28 38±4 33) percent, t =4 055, P <0 01〕. The time of bringing down the fever and the time of absorption of pathological changes in SARS patients were prolonged than those of the pneumonia patients 〔the time of bringing down the fever (13 92±8 35) days vs. (3 86±1 42)days, t =16 490, P =0 000; the time of absorption of pathological changes: (11 97±4 41)days vs. (9 21±4 42)days, t =3 082, P =0 003〕. Conclusion: SARS is a serious respiratory illness, The most common symptoms are fever, cough, headache and myalgia, other common findings are lymphopenia, the CD + 4 and CD + 8 in T cell in peripheral blood decrease and multiinfiltrate through out the lung fields.