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目的:了解 SARS 合并腹泻患者的临床特点,并探讨其致病机制.方法:对118例(19例有腹泻,99例无腹泻)SARS 患者临床资料进行回顾性分析.结果:19例(16.1%)SARS 患者有水样便症状,2-6次/d 不等,量约100-200 mL/次,持续1-3d,多数患者有发热,但无明显的消化道症状及脱水表现,大便检查无明显的异常改变.腹泻及非腹泻患者有接触疫史例数分别为18例(94.7%)和80例(80.8%),P=0.25;两组的潜伏期分别为6.8±3.1(3-10 d)和7.6±4.3(2-18d),P>0.5;两组的重患者及死亡病例比相近,分别为15.8%(3/19)和20.2%(20/99)、5.3%(1/19)和4.0%(4/99),两组患者均可出现发热、肌肉酸痛、干咳的、关节痛、咳痰、咯血及胸闷气短等症状(P>0.1);二者出现肝功能异常、LDH/HBDH 升高及WBC 减少的例数比也相近(P>0.01);腹泻组 SARS-Cov IgG 抗体的阳性率为76.5%(13/17),非腹泻组为72.7%(64/88).结论 SARS 冠状病毒可侵犯胃肠道,引起水样腹泻,但症状轻,持续时间也较短;而且腹泻对 SARS 整个疾病的其他临床表现、病情的轻重和预后影响不大.
Objective: To investigate the clinical features of patients with SARS complicated with diarrhea and to explore its pathogenesis.Methods: The clinical data of 118 cases (19 cases with diarrhea and 99 cases without diarrhea) were retrospectively analyzed.Results: Nineteen cases (16.1% SARS patients with watery symptoms, ranging from 2-6 times / d, the amount of about 100-200ml / time for 1-3d, the majority of patients with fever, but no obvious gastrointestinal symptoms and dehydration performance, stool examination There were no significant abnormal changes in the number of cases of diarrhea and non-diarrheal disease in patients with contact history were 18 cases (94.7%) and 80 cases (80.8%), P = 0.25; two groups were 6.8 ± 3.1 (3-10 d, and 7.6 ± 4.3 (2-18d), P> 0.5. The rates of severe cases and deaths in the two groups were similar and were 15.8% (3/19), 20.2% (20/99) and 5.3% (P> 0.1). Both of them had liver dysfunction, fever, muscle soreness, dry cough, arthralgia, sputum, hemoptysis and chest tightness, shortness of breath and other symptoms The positive rate of SARS-CoV IgG antibody was 76.5% (13/17) in diarrhea group and 72.7% (64/88) in non-diarrhea group, and the number of patients with elevated LDH / HBDH and WBC decreased (P> 0.01) Conclusion The SARS coronavirus can invade the gastrointestinal tract and cause watery diarrhea, but the symptoms are mild , Duration is also shorter; and diarrhea on the SARS disease, the other clinical manifestations, severity and prognosis has little effect.