【摘要】 目的　研究深圳地区传染性非典型肺炎患者的临床特点。方法　对深圳地区 4 6例传染性非典型肺炎患者的年龄、性别、流行病学资料、临床表现、实验室资料及预后进行分析。结果　男∶女 =1.3∶ 1,平均30 .5岁。儿童发病率较低 ,且一般不转为重症 ;>4 5岁的中老年人易转为重症。具有传染性强 ,易家庭聚发及单位群发的流行病学特点。易重症化 (4 7.2 6 % ) ,病死率为 4 .3% ,易发生I型呼衰 (15 .2 % )。所有患者均有发热 ,热程平均 (9.0 7± 4 .2 3)d ,多为弛张热。重症患者热程长于普通患者。大多数患者均有呼吸道症状。胸片示肺部炎症改变出现时间多为发热后 3～ 4d ,持续时间平均 (16 .7± 10 .3)d。重症患者肺部炎症持续时间长于普通患者 (P <0 .0 5 ) ,易发生肺纤维化 (34.78% )。易发生肝功能损害。重症患者更易发生肝功能损害 (P <0 .0 0 5 ) ,且损害程度较重。CD4 + /CD8+ 细胞计数入院时平均为 (17.9± 5 .6 ) % / (2 4 .2± 6 .5 ) % ,明显下降。重症患者CD4 + /CD8+ 细胞计数为 (12 .6± 4 .5 ) % / (19.6± 9.5 ) % ,下降更明显。结论　传染性非典型肺炎患者的年龄、热程、肺部炎症持续时间、肝功能损害明显、CD4 + /CD8+ 细胞计数明显下降等可作为早期判断SARS患者重症化的指标。更多还原

【Abstract】 Objective: To study the clinical features of patients with infectious untypical pneumonia in Shenzhen. Methods:To analyze the age, gender, epidemiology, clinical manifestation and prognosis of patients with confirmed infectious untypical pneumonia in Shenzhen.Results: Male to female ratio, 1.3∶1; mean age, 30.5 years, low morbidity and no severe cases for children, but aptness to develop severe diseases for patients at age over 45 or pregnancy. Highly infectious and clustered incidences in family or unit was detected in epidemiology research. Patients were apt to develop severe diseases (47.26%) and respiration failure type I (15.2%) with mortality of 4.3%. Fever appeared in all cases and its duration was (9.07±4.23) days on average. The pneumonia appeared 3 to 4 days after a fever and lasted for (16.7±10.3) days. Respiratory symptoms appeared in most cases (P<0.05). Apt to develop pulmonary fibrosis (34.78%) and liver function damage . Furthermore, the severe cases were prone to develop pulmonary fibrosis and more serious liver function damage than non severe cases as well (P<0.005). At admission, the CD4+/CD8+ cell numbers decreased evidently with an average level of (17.9± 5.6)%/(24.2± 6.5 )%.The CD4+/CD8+ cell number is (12.6±4.5)%/(19.6±9.5)%,and reduce clearly more. Conclusion:The age, gender, fever duration, bilateral pneumonia and its duration and liver function damage may be used as its duration and liver function damage may be used as indexes to judge whether patients with infectious untypical pneumonia are apt to develop severe diseases and pulmonary fibrosis. The evident decrease of CD4+/CD8+ may be used as a supplementary diagnosis standard.更多还原