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目的 研究SARS早期的临床特点。方法 对 5 3例SARS早期病例的流行病学、临床、实验室及影像学资料进行回顾性分析。结果 5 3例患者中男性 2 4例 ,女性 2 9例 ,平均年龄 (38±16 7)岁 (10～ 85岁 ) ,发病年龄以 2 0～ 5 0岁患者居多 (6 7 9% ) ,平均潜伏期 (7 3± 7 0 )d (3～ 14d) ,职业分布居多者为职员 (11例 ,占 2 0 8% ) ,其次是医护人员 (9例 ,17 0 % )。临床症状以发热 (10 0 % ) ,咳嗽 (49 1% ) ,肌肉酸痛 (2 4 5 % ) ,乏力 (17 0 % ) ,胸闷憋气 (2 0 8% ) ,腹泻 (5 7% )等为主要表现。在病程的第 1～ 5天患者白细胞 <4 0× 10 9 L 33例 (6 2 3% ) ,(4 0～ 10 0 )× 10 9 L 18例 (34 0 % ) ,6 7 9%患者淋巴细胞计数减少 ,13 2 %患者血小板计数减少。X线胸片主要病变呈肺部斑片状渗出性阴影 ,其中双侧受累占 15 1% ,单侧受累 75 4 %。血气分析示PO2 <90mmHg (1κPa =7.5mmHg) 2 6例 (占4 9 1% ) ,出现酸碱平衡紊乱者 9例 (17 0 % ) ,其中代谢性酸中毒 4例 (10 8% )及代谢性碱中毒合并呼吸性酸中毒 4例 (10 8% )。SARS常合并多脏器损伤 ,其中肝功能 (ALT、AST)异常占 37 7% ,肾功能(BUN、SCR)损伤占 11 3% ,心肌酶 (LDH、CK、HBDH)异常占 4 3 4 %。结?
Objective To study the clinical features of early SARS. Methods The epidemiological, clinical, laboratory and imaging data of 53 early SARS cases were retrospectively analyzed. Results There were 24 males and 29 females with an average age of 38 ± 16 7 years (range, 10 to 85 years). The age of onset was mostly in the range of 20 to 50 years (69.9%), The average incubation period was (73 ± 70) d (3 ~ 14 days). The majority of occupations were staff (11 cases, 20.8%), followed by medical staff (9 cases, 17 0%). Clinical symptoms were fever (100%), cough (49.1%), muscle soreness (245%), fatigue (17 0%), chest tightness and suffocation (20.8%) and diarrhea main performance. In the first to fifth days of the course of disease, there were 33 (62.3%) leukocytes, 18 (34.0%) cases (40.0%) and 109.9% of the patients Lymphocyte count decreased, 13 2% of patients with reduced platelet count. The main lesions of X-ray showed patchy exudative pulmonary shadows, including bilateral involvement 15 1%, 75 4% unilateral involvement. Blood gas analysis showed 26 cases (491%) with PO2 <90mmHg (1|ÌPa = 7.5mmHg), 9 cases (17%) with acid-base balance disorder, among which 4 were metabolic acidosis Metabolic alkalosis with respiratory acidosis in 4 cases (108%). SARS is often associated with multiple organ injury, including abnormal liver function (ALT, AST) 37 7%, renal function (BUN, SCR) injury 11 3%, myocardial enzymes (LDH, CK, HBDH) . Knot?