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目的通过对SARS患者含漱液内冠状病毒定量与临床转归的相关性的初步研究,以期能建立起客观的SARS重症救治早期预警指标。方法对2003年4~5月在本院诊断的90例SARS成年患者,77例SARS密切接触者进行含漱液的实时荧光定量(RT-PCR)方法检测SARS病毒定量,将其结果与临床转归进行对比分析。结果77例SARS密切接触者含漱液中病毒检测均为阴性,90例SARS病人病程第5~11天含漱液内病毒检测48例为阳性,且21例病毒定量>1.0×102copies/ml者中的9人出现ARDS,6人死亡,与病毒定量阴性或病毒定量<1.0×102copies/ml者比较仅各1例发展至ARDS,1例死亡,具有显著性差异。结论含漱液用于检测SARS病毒核酸对于早期诊断和未发病者的监测有着重要的意义。含漱液内SARS病毒定量高者有可能成为“超级传播者”。SARS患者的含漱液内冠状病毒定量愈高提示疾病愈可能是重型,应加强监护,及早治疗,以期提高治愈率,降低病死率,是客观的SARS重症救治早期预警指标,应引起重视。
OBJECTIVE: To study the relationship between the quantification of coronavirus in patients with SARS and the clinical outcome in order to establish an objective early warning indicator of severe SARS. Methods Ninety SARS patients diagnosed in our hospital from April to May in 2003 and 77 SARS patients were closely intervened to carry out a gargle quantitative real-time fluorescence quantitative (RT-PCR) method to detect the SARS virus. The results were compared with the clinical data To carry out comparative analysis. Results The results showed that all the 77 SARS patients who were in close contact with gargling were negative in the detection of gargles, 48 of 95 SARS patients were positive in gargle from the 5th to 11th of the course, and 21 of them were> 1.0 × 102 copies / ml ARDS occurred in 9 of 9 patients, and 6 patients died of ARDS. Only 1 patient developed ARDS and 1 patient died when compared with virus-negative or virus-negative <1.0 × 102copies / ml, with significant difference. Conclusions The use of gargle for detecting SARS virus nucleic acid is of great significance for early diagnosis and non-onset monitoring. The highest quantification of the SARS virus in gargle may be a “super-communicator.” SARS patients gargle with higher quantitative coronavirus disease suggests that the more likely to be heavy, intensive care should be strengthened, early treatment, in order to improve the cure rate and reduce mortality, is an objective SARS severe early warning indicators of salvage should be taken seriously.