【摘要】 目的 :在严重急性呼吸综合征 (SARS)流行的背景下 ,为SARS和其它病毒性肺炎进行诊断和鉴别诊断提供依据。方法 :对上海市第五人民医院 2 0 0 3年 4月 12日～ 6月 5日收治的 10例成人社区获得性病毒性肺炎流行病学史、临床特征、实验室检查、微生物学检查、影像学、治疗和预后进行回顾性分析。结果 :符合SARS流行病学特点 1例 (10 % ) ,符合流感流行病学特点 3例 (30 % )。主要临床症状 :发热 (10 0 % )、咳嗽 (70 % )。就诊时白细胞 (WBC)计数减低 3例 (30 % ) ,中性粒细胞百分比(NEUT % )增高 5例 (5 0 % ) ,淋巴细胞百分比 (LYMPH % )减少者 3例 (30 % )。病原学检查 :流感病毒 7例 (70 % ) ,副流感病毒 2例 (2 0 % ) ,1例SARS病原学检查结果阴性。就诊时异常的胸部X线片表现以肺实质阴影为主。进展 3例 (30 % ) ,阴影在下肺 9例 (90 % )、心缘旁 3例 (30 % )、单侧 9例 (90 % )、双侧 1例 (10 % )。全部病例经治疗后痊愈出院。结论 :相对SARS ,成人社区获得性流感病毒性肺炎具有发热不反复、肺内病灶单发、病程短、预后好的特点 ,对SARS的诊断更应注意流行病学及恰当时机反复病原学检测。更多还原

【Abstract】 Objective: To provide the basis for the diagnosis and differrential diagnosis between SARS and other Viral pneumonias under the background of sars prevalence. Methods: Ten patients with Community-acquired Viral pneumonias in adults referred to the Shanghai Fifth People’s Hospital ,from April 12,2003 to June 5,2003 Were studied retrospectively.The data reviewed included those history of epidemiology, clinical manifestations, laboratory investigation , microorganism examination , roentgenology ,treatment and prognosi.Results: The behavior of epidemiology coincided with SARS in 1 patient(10%)and with Influenza in 3 patients(30%).clinical symptoms of these patients were mainly fever(100%),coughing(70%).There were lower WBCs in 3 patients(30%),higher NEUT% in 5 patients(50%)and lower LYMPH% in 3 patients(30%). The influenza viruses were found in 7patients(70%), the parainfluenza viruses were found in 2 patients(20%),negative result was found in a SARS patient. The mainly abnormal chest radiographs were Initially showed lung opacity in patients . progressive radiographic deterioration ( 3 of 10, 30%),lower lung zone (9 of 10, 90 %), para-cardiomargin zone (3 of 10, 30 %), unifocal involvement (9 of 10, 90%), bilateral involvement(1 of 10, 10%).All patients fully recover from illnesses.Conclusion: Compared with SARS, the Community-acquired Influenzavirus pneumonias in adults have some features, such as unrecurrent fever, unifocal lung involvement, short progress, good prognosi.We should pay more attention to the history of epidemiology and repeated microorganism examination in appropriate time when diagnose SARS.更多还原