汕头地区传染性非典型肺炎研究

Study of Severe Acute Respiratory Syndrome in Shantou

目的 :探讨传染性非典型肺炎 (IAP)的流行病学、临床特点、病原学检查及预后。方法 :根据中国卫生部IAP临床诊断标准。采用间接免疫荧光法检测抗冠状病毒IgG。分析本组 (8例 )病例特点 ,患者均有密切接触史 ,潜伏期 1～10天 ;均发热 ,且热型多不规则。胸片特点 :本组肺部均出现片状或斑片状炎症阴影。常规予广谱抗生素、利巴韦林抗病毒以及免疫球蛋白、生物反应调节剂胸腺肽等治疗无效 ,予甲基强的松龙治疗有效。结果 :本组均符合IAP临床诊断标准。 7例存活者于半个月～ 2个月内肺部炎症阴影均完全吸收。 1例死于呼吸衰竭。住院时间 14～ 4 4天 ,平均 (2 8 9± 13 7)天。 3例抗冠状病毒IgG阳性 ,且恢复期的抗体滴度比急性期增高 4倍以上。结论 :IAP是一种传染性极强的疾病。本组以近距离传播为主 ,具有家族局部爆发流行的特点。以发热为主要表现 ,热程多在 14天左右 ,重症者可长达 30多天。该疾病侵犯多个肺叶 ,及肺部以外的其他器官。激素可以促使肺部炎症的吸收。

Objective: To investigate the epidemiology,clinical features, chest radiography,and prognosis of the patients with severe acute respiratory syndrome(SARS)in Shantou.Methods:Sera of 3 patients both the acute phase and the convalescent phase were detected the anti-coronavirus IgG by the indirect immunofluorescence assay. All the patients with fever had a close contact with the patients of SARS diagnosed.Incubation period was one to 10 days. The patchy-or-cloudy-type opacities were found on the chest X-ray.The titers of SARS anti-coronavirus IgG of the sera of 3 patients in the acute phase were five times as much,compared with the convalescent phase.The average in-hospital time was(28.9±13.7)d.One case died of respiratory failure. Conclusion: SARS is a highly infectious disease.Its course is about fourteen days in general patients and thirty days and more in severe cases. The SARS can invade some organs such as liver,with the exception of lungs. Glucocorticoid is useful for improving viremia and preventing disease progress and fibrosis of the lungs. SARS coronavirus is an etiological agent in patients with SARS.