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目的 探讨严重急性呼吸综合征(SARS) ,特别是重症SARS的临床特点。方法 对解放军第 30 2医院收治的 70例SARS患者的临床资料进行回顾性分析。结果 患者年龄 10～ 74岁 (33 81± 12 73岁 ) ,其中重症 38例 ,非重症 32例。其症状主要表现为 :发热、乏力、咳嗽、气促、头痛等 ,热程为 7 2 0± 4 5 7天。根据胸片表现及症状把SARS分为初期、进展期、恢复期 ,各期时间为 3 19± 2 32、8 18± 4 36、8 82± 7 0 1天。随着年龄增高重症比例增高 ;重症SARS体温较非重症组难控制 (最高体温 38 74± 0 97℃和 38 0 2±0 14℃) ,病程明显较非重症组长 (2 7 78± 9 99天与 14 93± 5 80天 ) ;重症组ALT、LDH、HBDH升高比例也较非重症组明显增高 (ALT :78 95 %与 5 0 0 0 % ;LDH、HBDH :4 2 11%与 18 75 % )。年龄大 ,合并慢性疾病 ,LDH、HBDH明显升高是预后不良的预测因素之一 ;治疗以综合方疗法为主 ,经验性使用糖皮质激素对阻止病情进展有一定疗效。结论 重症SARS虽然病情较重 ,死亡率高 ,但经综合治疗可取得较好疗效。
Objective To investigate the clinical features of severe acute respiratory syndrome (SARS), especially severe SARS. Methods The clinical data of 70 SARS patients admitted to the 30th Hospital of People’s Liberation Army were retrospectively analyzed. Results The patients were 10 to 74 years old (33 81 ± 12 73 years old), including 38 severe cases and 32 non-severe cases. The main symptoms are: fever, fatigue, cough, shortness of breath, headache, fever range of 7 2 0 ± 45 57 days. According to the manifestations and symptoms of chest X-ray, SARS was divided into initial stage, advanced stage and convalescent stage. The duration of each stage was 3 19 ± 2 32,8 18 ± 4 36,8 82 ± 7 0 1 days. The severity of severe SARS was more difficult to control than the non-severe (38 74 ± 0 97 ℃ and 38 0 2 ± 0 14 ℃), and the course of disease was significantly higher than that of the non-severe head (2 7 78 ± 9 99 Day and 14 93 ± 5 80 days). The proportion of ALT, LDH and HBDH in critically ill patients was also significantly higher than that in non-severely ill patients (ALT: 78 95% vs 500%; LDH, HBDH: 42.11% and 18 75%). Older age, combined with chronic diseases, LDH, HBDH increased significantly higher prognosis is one of the predictors of poor prognosis; treatment of comprehensive treatment-based, empirical use of glucocorticoids to prevent the progression of the disease have a certain effect. Conclusion Severe SARS, although the condition is severe, the mortality rate is high, but the comprehensive treatment can achieve better curative effect.