深圳3簇严重急性呼吸综合征传染链病例分析

Analysis of Three Clusters of Patients with Severe Acute Respiratory Syndrome in Shenzhen

目的 了解深圳 3簇严重急性呼吸综合征 (severeacuterespiraterysyndrome,SARS)的病例特点。 方法 对深圳 3簇SARS病例进行回顾性流行病学调查 ,分析其临床表现及实验检查结果的特点。结果 第 1簇为同事 2人 ,其中深圳首发病例 1周内往返香港 2次 ,于第 2次 (2 0 0 3年 1月 14日 )在香港发病 ;第 2例从香港回深圳后发病。第 2簇一家 5人于广州某医院探病后 1周内先后发病。第 3簇为父子 2人 ,父亲入院前 2周曾往返香港。临床症状均表现高热 ,其中 3例畏寒 ,5例全身肌肉酸痛 ,5例干咳 ,2例咽痛 ,4例头痛 ,2例头晕 ,3例于发病 1周出现气喘伴腹泻并发展成ARDS。 6例在发病 2周内检测冠状病毒相关抗体阳性 ,其中 1例发病后 12 0天的IgG抗体滴度仍为 1:6 4 0。死亡病例的中性粒细胞百分比及中性粒细胞绝对值增高 ,而淋巴细胞百分比及淋巴细胞绝对值降低 ,随着病情加重乳酸脱氢酶明显增高。结论 三簇病例多为异地感染发病 (输入性和散发性 )。在SARS病例中 ,检出冠状病毒相关IgG抗体。

Objective To study the epidemic and clinical characteristics of three clusters of early cases of severe acute respiratery syndrome(SARS) in Shenzhen. Methods To retrospectively investigate three clusters of patients. To extract data on clinical presentation and laboratory studies. Results In the first cluster, one patient with SARS in Shenzhen had visited Hong Kong twice in one week. He had felt initial cold and fever in Hong Kong on January 14, while the second case had been onset of SARS when he had been back from Hong Kong. There were 5 people infected in the second cluster at the same time 1 week after they visited their father in a hospital in GuangZhou. Among the three clusters, two clusters had not been infected in ShenZhen, they are inputted, and another cluster is not clear, but it maybe inputted. Three clusters are distributed, they all had high fever. Among them, five had total body muscular soreness and unproductive cough, four with headache, three chill, and two dizziness and pharyngalgia. Three cases had asthma and diarrhea 1 week after the onset of SARS, and progressed to ARDS. The six patients with SARS in Shenzhen People's Hospital tested positive for coronavirus-related anti-body (IgG) in their plasma 10-15d after the onset. This IgG titres in one patient remained high (1: 640) 120 days after the onset. Neutrophilia and lymphopenia occurred in patients who died. The more severe the patients condition was, the higher was the level of LDH increased. Conclusion In three clusters, most patients had not infected in Shenzhen, they are inputted and distributed. That patients with SARS tested positive for coronavirus-related IgG in their plasma.