河南省传染性非典型肺炎病例临床分析

Clinical analysis of 15 cases of severe acute respiratory syndrome in Henan

目的 :分析河南省传染性非典型肺炎 (SARS)的临床特点 ,并对其诊断和治疗方法进行探讨。方法 :对2 0 0 3年 4月至 2 0 0 3年 6月河南省收治的 1 5例SARS患者的症状、体征、实验室检查、影像学资料及治疗进行回顾性分析。结果 :1 5例传染性非典型肺炎患者男 :女为 1 :1 .5 ,年龄 2 0～ 5 3岁 , x±s(34.4± 9.9)岁。有明确流行病学接触史 1 1例 (73.3% )。潜伏期 4～ 1 0d , x±s(6 .6± 1 .7)d。主要症状包括 :发热 1 5例 (1 0 0 % ) ,乏力 1 3例 (87.6 % ) ,咳嗽 1 2例 (80 % ) ,呼吸困难 1 0例 (6 6 .7% ) ,畏寒或寒颤 5例 (33.3% ) ,咳痰 3例 (2 0 % )。体征包括 :呼吸增快 7例 (4 6 .7% ) ,紫绀 4例 (2 6 .7% )。WBC >1 0 .0× 1 0 9L-1 2例 (1 3.3% ) ,(4 .0～ 1 0 .0 )× 1 0 9L-1 1 1例 (73.4 % ) ,<4 .0× 1 0 9L-12例 (1 3.3% ) ,淋巴细胞计数≤ 1 .0× 1 0 9L-1 9例 (6 0 % ) ,(1 .0～ 2 .0 )× 1 0 9L-1 3例 (2 0 % ) ,>2 .0× 1 0 9L-1 3例(2 0 % )。首次胸部X线片示病变累及双侧肺叶 9例 (6 0 % )、单侧多叶 6例 (4 0 % ) ,病变发展到高峰时间 4～ 1 4d , x±s(7.7± 3.2 )d、病变开始吸收时间 6～ 2 1d , x±s(1 1 .3± 4 .1 )d、病变完全或基本吸收时间 8～ 2 6d , x±s(1 6 .4± 5 .0 )

Aim: To analyze the clinical features of Severe Acute Respiratory Syndrome (SARS) and to explore the diagnosis and treatment of SARS. Methods:A total of 15 patients with SARS referred to Henan, China from April 2003 through June 2003 were studied retrospectively. The reviewed data included clinical manifestations, laboratory investigati-on, and roentgenology. Results: The 15 patients were collected: 6 men and 9 women, aged 20～53 years (mean 34.4±9.9 years), incubation period 4～10 day (mean 6.6±1.7 days). Clinical symptoms of these patients included fever (100%), inertia (87.6%), coughing (80%), dyspnea (66.7%) and chilling (33.3%). Routine blood test revealed WBCs >10.0×10 9/L in 2 patients (13.3%), (4.0～10.0)×10 9/L in 11 patients(73.4%),<4.0×10 9/L in 2 patients (13.3%) and lymphocyte count ≤1.0×10 9/L in 9 patients (60%), (1.0～2.0)×10 9/L in 3 patients(20%), >2.0×10 9/L in 3 patients (20%).The initial chest X-ray and CT scanning revealed changes related to pneumonia. The main abnormal appearance was single or bilateral local patchy clouding opacity on roentgenography, which progressed rapidly. The area of opacity peaked from 4 to 14 days (mean 7.7±3.2 days). The opacity disappeared gradually from 8 to 26 days (mean 16.4±5.0 days). All patients in the investigation were cured by using ribavirin, glucocorticoid, and drugs of anti-infection. Conclusions: A history of close contact, fever, X-ray signs of pneumonia, normal WBC counts and lowered lymphocyte count are favorable for the diagnosis of SARS. Reasonable therapy and comprehensive supportive management are of paramount importance in the rehabilitation of the patients with SARS.