SARS伴腹泻病例的临床特点

Clinical characteristics of SARS patients with diarrhea:A report of 12 cases

目的:了解 SARS 合并腹泻患者的临床特点,并探讨其致病机制.方法:对118例(19例有腹泻,99例无腹泻)SARS 患者临床资料进行回顾性分析.结果:19例(16.1%)SARS 患者有水样便症状,2-6次/d 不等,量约100-200 mL/次,持续1-3d,多数患者有发热,但无明显的消化道症状及脱水表现,大便检查无明显的异常改变.腹泻及非腹泻患者有接触疫史例数分别为18例(94.7%)和80例(80.8%),P=0.25;两组的潜伏期分别为6.8±3.1(3-10 d)和7.6±4.3(2-18d),P>0.5;两组的重患者及死亡病例比相近,分别为15.8%(3/19)和20.2%(20/99)、5.3%(1/19)和4.0%(4/99),两组患者均可出现发热、肌肉酸痛、干咳的、关节痛、咳痰、咯血及胸闷气短等症状(P>0.1);二者出现肝功能异常、LDH/HBDH 升高及WBC 减少的例数比也相近(P>0.01);腹泻组 SARS-Cov IgG 抗体的阳性率为76.5%(13/17),非腹泻组为72.7%(64/88).结论 SARS 冠状病毒可侵犯胃肠道,引起水样腹泻,但症状轻,持续时间也较短;而且腹泻对 SARS 整个疾病的其他临床表现、病情的轻重和预后影响不大.

AIM:To summarize the clinical features of SARS patients with diarrhea and to discuss its mechanism. METHODS:In a total of 118 clinical diagnosed SARS patients (19 cases with diarrhea),contact history of SARS patients, symptoms of the patients and a series of laboratory tests were investigated. RESULTS:A total of 16.1%(19 cases)of SARS patients presented mildly diarrhea and recovered quickly without any specific treatment.18 of 19 patients presented diarrhea had a contact history to SARS patients,80 of 99 cases of non-diarrhea patients had a contact history to SARS patients,and their average incubation periods were 6.8± 3.1 days(ranged 3 to 10 days)and 7.6±4.3 days(2 to 18 days)respectively(P>0.05).The symptoms and the labo- ratory tests(such as,serum aminotransferas,creatinine kinase levels,and leukopenia)of patients in both groups were similar(P>0.05).There were 3 severe cases(15.8%) and 20 severe cases(20.2%)in two groups respectively. One case(5.3%)of 19 patients with diarrhea died and four cases(4.0%)in total 99 non-diarrhea patients. CONCLUSION:About 16.1%(19 cases)of SARS patients present mildly diarrhea and recovered quickly without specific treatment,and their clinical features,clinical condition, laboratory features and prognosis are similar to that of the patients without diarrhea.