The Analysis of Clinical Features, Treatment and Outcomes of Patients with Several Acute Respiratory Syndrome (SARS)

摘要

Objective To analyze the clinical features and treatment outcomes of SARS patients in Beijing region. Methods Retrospective Analysis method was used to analyzed the clinical, laboratory, pathological data in 108 cases of SARA patients. Results (1) The patients with mild and covert infection; (2) The clinical features of patients with typical SARS symptoms contain four phases, that is, early period (prodromal period), progressing period, fastigium period and recovery phase; The most severe phase is in the progressing and fastigium periods. Rational uses of hormones and breathing machine in early stage can prevent the progress of the disease; (3)The concept of fulminant SARS was brought forward, suggesting that strong infectivity and high fatality rate should be noticed by physicians; (4) The laboratory results: ①CD3, CD4, CD8 were reduced. In the 10th～14th day, these indicators returned to the lowest values . The levels of reduction were positive proportional to the patients' disease condition. CD4 was not significantly effected by the use of hormone; ②The parameters were significantly reduced in early stage: total count of WBC, lymphocytes and their ratio, Prealbumin, transferring;③The following parameters were significantly increased in early stage: C reaction protein, α - acid glycoprotein and α_2 globulin; ④Liver function was impaired mildly or fairly in the mid - term of the disease stage. (5)Corpse examination. The significant pathological changes were pulmonary edema, the formation of hyaline membrane, capillary impairment, hyperplasia, edema in alveoli and transudation, fiber and other components were formed in alveolar cavum. The image features of SARS. The changes in CT image were found 3 days earlier than x - ray image in some SARS patients. The singular or multiple focal transudation, mainly located in lower part and outer part of lungs were found in early stage of SARS patients. In the progressing period, milling glass like - image and consolidation image were enlarged and even widespread to whole lungs. The singular or multiple Cotton - mass - like image and milling glass like - image were found in early HRCT. Mass milling glass - like and consolidation image were found in progressing stage. Pulmonary interstitial fibrosis can be diagnosed by HRCT. Conclusion SARS is a newly found, strongly contagious disease, which mainly impairs respiratory tract and immune system. The clinical symptoms of SARS are diversified. The taxonomy of 5 type - 4 stages can be used to help doctors to judge the disease condition and guide clinical treatment. Early rational treatment with hormone and use of non - invasive respiratory machine can reduce the fatality rate. The fibrosis of lungs as a sequela has been found in some recovered patients.