【摘要】 目的　通过对重症SARS患者相关危险因素的分析 ,指导临床医生及时、准确判断病情。方法　采用回顾性方法对比总结 4 0例重症患者与 4 3例普通型患者临床资料。结果　普通型患者年龄构成比小于 4 0岁占 98.2 % ,5 0岁以上均为重症患者。重症患者高热持续时间长 ,平均 7.7d ,激素干预 3d体温仍不降或下降后复升者占 36 .4 % ;合并腹泻的比例高 (占 4 5 .0 % ) ,持续时间平均 6d。重症、普通型患者淋巴细胞记数 (L cell<1.0× 10 9/L)的比例分别占 91.7%、38.0 % ,且 15d内进行性下降的比例重症患者为 4 1.2 %。T细胞亚群中CD4 、CD3明显下降在重症患者中所占比例 (81.3%、5 2 .9% )较普通型高 (5 0 .0 %、2 2 .2 % )。结论　重症SARS的相关危险因素为 (1)年龄大于 5 0岁 ;(2 )持续高热 ,应用激素 3d体温不降或复升 ;(3)持续腹泻超过 6d ;(4)淋巴细胞计数 2周内进行性下降 ;(5 )血清酶系统升高大于正常值 2倍。更多还原

【Abstract】 Objective Informing and providing help for the clinicians to judge the state of SARS cases punctually and actually by analyzing the risk factors of serious SARS cases.Methods Making comparison of 40 serious cases with 43 ordinary SARS cases retrospectively.Results In ordinary cases 98.2% of the cases were under 40 years old.All serious cases were over 50 years old.Most serious SARS cases had longer fever time with an average of 7.7 days.36.4% of the cases got fever lasted for more than 3 days or rose after descending on steroid therapy.45.0% of the cases companied with diarrhea for the average period of 6 days.The lymphocyte counting (L-cell<1.0×10 9/L) took 91.7% and 38.0% separately in serious and ordinary cases with 41.2% of the serious cases showed steady descending in 15 days.The decrease of T cell subgroup,CD 4 and CD 3 in serious SARS cases (81.3% and 52.9% separately) was much higher than that in ordinary cases (50.0% and 22.2% separately).Conclusion The risk factors of serious SARS cases include age over 50 years,continuous fever with no effect on steroid therapy for 3 days or the temperature raises after descending,diarrhea over 6 days,lymphocyte counting descending steadily in 2 weeks period and serum enzyme raise twice over normal level.更多还原