严重急性呼吸综合征7例临床分析

Clinical analysis of severe acute respiratory syndrome (an analysis of 7 cases)

目的 :总结严重急性呼吸综合征 ( SARS)的临床特点。方法 :对严重急性呼吸综合征 7例与疑似严重急性呼吸综合征 1 3例临床症状、体征及各项检测指标 ,特别对咽部黏膜表现进行了观察对比。结果 :临床诊断及疑诊 SARS病例临床初期均有白细胞下降或正常 ,以及胸部 χ线异常 ,但两者咽部黏膜表现有所不同 ,1 3例疑似病例均有明显的咽部炎症 ,淋巴滤泡密集覆盖软腭 ,经抗菌、抗病毒治疗后 1周内好转 ,7例临床诊断 SARS病例咽部炎症不明显 ,经抗菌、抗病毒治疗后临床症状未见明显好转 ,且多在病程 1 0 d后加重。结论 :目前 SARS临床诊断标准尚缺乏特异性指标 ,病毒学和血清学诊断在多数医院尚不能开展或及时报告。

Objective: To summarize the clinical characteristics of severe acute respiratory syndrome (SARS). Methods: To compare clinical symptoms and signs as well as the changes of various laboratory examinations, especially mucosal changes of pharynxes of 7 cases with confirmed SARS and with that of 13 suspicious SARS patients. Results: In the early phase of the diseases, both showed abnormal X-ray manifestations with normal or reduced white blood cells. But mucosal changes in pharynxes were different in confirmed and suspicious patients. All suspicious SARS patients had an obvious pharyngeal inflammation including a lot lymphoid follicles over soft palates, and showed a good response to the treatment with antibiotics and antiviral drugs in one week. In contrast, seven confirmed SARS did not have an obvious pharyngitis.The clinical symptoms did not been improved ,but had been deteriorated at day 10 after the onset after antibiotic and antiviral treatment. Conclusion: At present, the clinical diagnosis criteria for SARS still lack a specific parameter because in most hospitals virus and serum examinations to SARS virus do not carry out and reported. The present result demonstrated that pharyngeal mucosal changes should be paid more attentions to differentiate patients with fever of SARS or non-SARS.