冠状病毒IgG抗体阳性与阴性临床诊断严重急性呼吸综合征患者的临床特征与随访结果比较

COMPARATIVE STUDY OF CLINICAL CHARACTERISTICS AND PROGNOSIS OF CLINICALLY DIAGNOSED SARS PATIENTS WITH POSITIVE AND NEGATIVE SERUM SARS CORONAVIRUS-SPECIFIC ANTIBODIES TEST

目的 探讨严重急性呼吸综合征 (SARS)的临床特点 ,研究该病对患者的长期影响。方法 回顾性统计分析了北京小汤山医院收治的 197例临床诊断SARS患者的临床资料 ,对患者预后进行了随访。结果 冠状病毒IgG抗体检测结果阳性 15 3例 (77 7% ) ,阴性 4 4例 (2 2 3% )。SARS患者组与可排除SARS组平均年龄分别为 (40± 12 )岁与 (31± 12 )岁 ,男女比例分别为 1 0∶1 6与 2 1∶1 0 ,发热期间平均体温分别为 (38 5℃± 0 3℃ )与 (38 1℃± 0 4℃ ) ,发热持续时间中位数分别为7 0d(0 4～ 5 0d)与 2 3d(0 3～ 37d)。SARS患者组呼吸困难、全身酸痛与消化道症状的发生率较可排除SARS组高。少部分患者遗留有咳嗽 ,乏力 ,呼吸困难 ,肝功能异常 ,空腹血糖、血脂升高等 ,个别患者遗留有程度不等的纤维化及弥散功能减退。结论 临床诊断的SARS患者可能有相当一部分为误诊病例。SARS与常见呼吸系统感染的临床表现明显不同。大多数患者恢复较好 ,部分遗留有肺功能障碍。随诊时要注意区分SARS后遗症与治疗药物的毒副作用。

OBJECTIVE TO INVESTIGATE CLINICAL CHARACTERISTICS AND LONG-TERM EFFECTS OF SARS. METHODS CLINICAL CHARACTERISTICS OF 197 SARS PATIENTS IN XIAO TANG-SHAN HOSPITAL WERE ANALYZED RETROSPECTIVELY, AND PROGNOSIS OF THEM WERE ANALYZED PROSPECTIVELY. RESULTS AMONG THE 197 PATIENTS, 153 PATIENTS(77.7%) HAVE POSITIVE RESULTS OF SERUM SARS CORONAVIRUS-SPECIFIC ANTIBODIES TEST ,AND 44 PATIENTS(22.3%)HAVE NEGATIVE RESULTS. THE AVERAGE AGE OF SARS AND NON-SARS PATIENTS WERE (40±12)AND (31±12) YEARS, MALE/FEMALE RATIO WERE 1.0∶1.6 AND 2.1∶1.0, AVERAGE BODY TEMPERATURE WERE (38.5℃±0.3℃) AND (38.1℃±0.4℃), MEDIAN OF FEVER LENGTH WERE 7.0 D(0.4～50 D) AND 2.3 D(0.3～37 D) RESPECTIVELY. THE OCCURRENCE OF DYSPNEA, MALAISE AND GASTROINTESTINAL SYMPTOM WERE MORE OFTEN IN SARS PATIENT THAN IN NON-SARS PATIENTS. SOME PATIENTS HAVE RESIDUAL SYMPTOMS (SUCH AS COUGH, FATIGUE, DYSPNEA, ABNORMITY OF LIVER FUNCTION, HYPERGLYCEMIA AND HYPERGLYCERIDEMIA), AND ONLY FEW PATIENTS HAVE LUNG FIBROSIS. CONCLUSION SOME PATIENTS WITH OTHER RESPIRATORY DISEASES WERE MISDIAGNOSED AS SARS. THERE WERE SEVERAL OBVIOUS DIFFERENCES OF CLINICAL CHARACTERISTICS BETWEEN SARS PATIENT AND NON-SARS PATIENTS. PROGNOSIS OF MOST PATIENTS WERE PRECIOUSLY WELL, AND FEW STILL HAD ABNORMITY OF LUNG FUNCTION. RESIDUAL SYMPTOMS OF SARS AND SIDE EFFECTS OF DRUGS USED TO TREAT SARS SHOULD BE DISCRIMINATED.