冠状病毒IgG抗体阳性与阴性临床诊断.pdf

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中华医学杂志2004年4月17日第84卷第8期 Natl Med J China, April17,2004,Vol84,No.8
临床论著
冠状病毒gC抗体阳性与阴性临床诊断
严重急性呼吸综合征患者的临床特征与
随访结果比较
田庆刘又宁解立新范保星许红民陈唯军
摘要】目的探讨严重急性呼吸综合征(SARS)的临床特点,研究该病对患者的长期影响。
方法回顾性统计分析了北京小汤山医院收治的197例临床诊断SARS患者的临床资料,对患者预
后进行了随访。结果冠状病毒gC抗体检测结果阳性153例(777%),阴性44例(22.3%)。
SARS患者组与可排除SARS组平均年龄分别为(40±12)岁与(31±12)岁,男女比例分别为1.0:1.6
与2.1:1.0,发热期间平均体温分别为(38.5℃±0.3℃)与(38,1℃±0.4℃),发热持续时间中位数分
别为7.0d(0.4~50d)与2.3d(0.3~-37d)。SARS患者组呼吸困难、全身酸痛与消化道症状的发生
率较可排除SARS组高。少部分患者遗留有咳嗽,乏力,呼吸困难,肝功能异常,空腹血糖、血脂升高
等,个别患者遗留有程度不等的纤维化及弥散功能减退。结论临床诊断的SARS患者可能有相当
部分为误诊病例。SARS与常见呼吸系统感染的临床表现明显不同。大多数患者恢复较好,部分遗
留有肺功能障碍。随诊时要注意区分SARS后遗症与治疗药物的毒副作用。
【关键词诊断:体征和症状;预后:严重急性呼吸综合症
Comparative study of inical characteristics and pro nosis of clinically dia nosed SARS patients with
positive and negative serum ARSS coronavirus-specific antibodies test T AN ing
ou-nnt
IE Li-xin, AN B-g U ongm, HM We atment of Pulmonary Medicine, General
Hospital of PLA, Beijing 100853, China
Correspondingauthor:LUYou-ning,Email:Liuyn@30hopital.com.cn
Abstrac Objective To invest gae clinical caracteristics and long-term effects of SARS
Methods Clinical
of 97 SARS patients in Xiao Tang-shan ho
retrospectively, and prognosis of them were analyzed prospective Results Among the 197 patients, 1
patients(77 7% )have positive results of serum ARS coronavinus-specific antibodies est and 44 patients
22. 3% ) have negative results. The average age of SARS and NON-SARS patients were(40# 12)and(31*
12 )years, male/female ratio were 1.0: 1.6 and 2. 1: 1. 0, average body temperature were(38.5C t
0.3℃)and(38.1℃±0.4℃), median of fever length were7.0d(0.4~50d)and2.3d(0.3~37d
respectively. The occurrence of dyspnea, malaise and gastrointestinal symptom were
often in SARS
patient than in NON-SARS patients, Some patients have residual symptoms( such
dyspnea, abnomity of liver unction, hyperglycemia and hyper lyceidemia) and only few patients have
lung fibrosis. Conclusion ome patients with other respiratory diseases were misdiagnosed as SARS, There
were several obvious if rences of clincal caress etw ARS patient and nonar atie
Prognosis of most patients were preciously well, and few still had abnormity of lung function. Residual
symptoms of SARS and side effects of drugs used to treat SARS should be discriminated
Key words) Diagnosis; Signs and symptoms; Prognosis; Severe acute respiratory syndrome
正确诊断严重急性呼吸综合征(SARS),避免误诊,是一非常重要又难以解决的问题,本研究随访了
197例临床诊断后在小汤山医院接受治疗的SARS
患者,分成抗SARS-CoV抗体阳性与阴性组(SARS
基金项目;国家“863”高新技术研究发展计划基金资助项目
(2003AA208107)
患者组与可排除SARS组),分别对其临床特征进行
作者单位:100853北京,解放军总医院呼吸科(田庆、刘又守、
回顾性分析,并进行康复期临床与实验室随访,以期
解立新、范保星、许红民);中国科学院北京基因组研究所(陈唯军
发现二者的区别,为临床鉴别诊断提供一些有帮助
通讯作者:刘又宁,Email:liuna@30Ihospita.com.cn
的资料。