146例成人重症SARS的临床分析

Clinical analysis of 146 patients with critical sever acute respiratory syndrome in Beijing areas

目的 分析重症严重急性呼吸综合征 (SARS)的临床特点。方法 回顾性分析 14 6例重症SARS患者的临床资料。结果 重症患者男女比例相当 ,年龄 18～ 86岁 ,4 1 1%有慢性疾病史 ,病死率为13 0 %。与轻症患者比较 ,其年龄、呼吸困难、再次发热、休克、X线胸片病变程度、淋巴细胞计数、动脉血气分析、T细胞亚群、心肌酶及部分生理学指标 ,差异有显著性 ;体温、发热天数、热型等差异无显著性。重症患者的多脏器衰竭、细菌感染、真菌感染的发生率高 ,抗生素和糖皮质激素用量大、用药时间长 ,使用抗病毒药、抗真菌药、呼吸机治疗的比例高于轻症患者。结论 呼吸困难、再次发热、淋巴细胞计数、T细胞亚群、X线胸片病变严重等是重症患者的主要临床特征 ,重症患者应综合治疗。

Objective To investigate the clinical characteristics of critical severe acute respiratory syndrome. Methods The cliaical data of 146 patients with critical SARS in Beijing were study retrospectively.Results Among the 146 patients, 72 males, 74females, aged 18-86 years. 41.1% were complicated by other chronic diseases.The mortality is 13.0%. The age, difficulty breathing, second fever, shock, X-ray chest radiography, lymphocyte count,artery blood gas, myocardium enzyme, subsets oft lymphocyte, and some physiological pridicators have significantlydifference in critical SARS, compared with those mild cases. But body temperature, duration of fever and type of fever,have no difference between the critical and the mild cases. Involvement of multiple organ, bacteria infection and fungus infection was open in the critical eases. Dosage and duration of Antibiotics and corticosteriods in the critical cases were blger and longer than the mild cases. Anti-viral drugs, anti-fungus drugs and machine ventilation were used more frequently, compared by the mild cases.Conclusion difficulty breathing, second fever, lymphocyte count, subsets of T lymphocyte, and X-ray chest radiography are the clinical characteristics of the critical SARS. The critical cases need general therapy.