41例老年严重急性呼吸综合征患者的临床特点和治疗分析

首都医科大学学报 ›› 2003, Vol. 24 ›› Issue (4): 380-384.

41例老年严重急性呼吸综合征患者的临床特点和治疗分析

冯明, 张建, 王香平, 王力红, 刘佑琴, 魏嘉平, 王育琴, 张泰昌, 贾强, 王立, 聂秀红, 杨强, 李宗信, 王克杰, 续大田, 李坤成, 尹建国, 韩玫, 徐玲, 丁秀娟

首都医科大学宣武医院SARS专家组

收稿日期:2003-07-23 修回日期:1900-01-01 出版日期:2003-10-15 发布日期:2003-10-15

Clinical Characteristics and Therapeutic Analysis of 41 Old-Aged SARS Patients

Feng Ming, Zhang Jian, Wang Xiangping, Wang Lihong, Liu Youqin, Wei Jiaping, Wang Yuqin, Zhang Taichang, Jia Qiang, Wang Li, Nie Xiuhong, Yang Qiang, Li Zongxin, Wang Kejie, Xu Datian, Li Kuncheng, Yin Jianguo, Han Mei, Xu Ling, Ding Xiujuan

Xuanwu Hospital, Capital University of Medical Sciences

Received:2003-07-23 Revised:1900-01-01 Online:2003-10-15 Published:2003-10-15

摘要/Abstract

摘要： 为分析老年严重急性呼吸综合征(SARS)患者的临床特点、治疗和转归,以提高治愈率。对我院2003年5月6日至6月27日收治的41例老年SARS患者的临床资料进行分析,并与同期住院的非老年SARS患者进行对比。结果老年SARS患者以发热为首发症状,以中等度热为主,高热、畏寒、寒战的发生率明显低于非老年SARS患者(P<0.05);老年SARS患者血淋巴细胞降低的发生率及T淋巴细胞亚群的水平明显低于非老年SARS患者(P<0.05);老年SARS患者血清白蛋白明显低于非老年SARS患者(P<0.01);老年SARS患者肺部体征的阳性率高,肺部X线胸片表现双侧多发病变的发生率明显多于非老年SARS患者(P<0.01);老年SARS患者治疗中并发精神障碍、二重感染的发生率明显多于非老年SARS患者,老年SARS患者并存基础病和并发症的发生率明显高于非老年SARS患者(P<0.01);病死率老年SARS患者为24.4%,显著的高于非老年SARS患者的5.5%(P<0.01)。提示我院收治的老年SARS患者临床以发热为首发症状,高热的发生率低,肺部表现以双侧多发病变多见,细胞免疫功能减低,临床分型重型和极重型比例高,并存基础病、并发症数量多,治疗复杂困难,病死率高。

关键词: 严重急性呼吸综合征, 老年人, 治疗

Abstract: The objective was to analyze the medical records,clinical characteristics,treatment and outcomes old-aged SARS patients,and try to improve the diagnosis and curative ratio of SARS.Clinical records of41old-aged SARS patients who were admitted to Xuanwu Hospital from May 6to June 27 in the year of 2003 were analyzed,and the data obtained were compared with those of 164 non-aged SARS patients who were admitted to the same hospital in the same period.Results:From the observation of the old-aged SARS patients,they were found more frequently having moderate fever(P<0.05),with the main manifestations of SARS,such as high fever,fear of coldness and chills,occurred less commonly than those of the non-aged SARSpatients(P<0.05).The incidence ratio of lymphopenia and the level of Tlymphocyte subgroups were obviously lower than the non-aged group(P<0.05).The serum albumin level of old-aged SARS patients was also evidently lower than the non-aged group(P<0.01).Chest X-ray showed that the bilateral multi-pathological changes occurredmore frequently than those in the non-aged group(P<0.01).The simultaneously occurred underlying diseases and complications occurredmore frequently than those of the non-aged SARS patients(P<0.01).Complicated mental disturbance and dual infection were more commonin the old-aged SARS patients than the non-aged SARS patients(P<0.01).The death rate of the old-aged SARS patients was24.4% which was remarkably higher than that of the non-aged SARS patients(5.5%,P<0.01).Conclusion:The old-aged SARSpatients admitted to Xuanwu Hospital showed a lower occurrance of high fever which is one of the main symptoms among SARS patients;They usually expressed multi-pathological lesions bilaterally in their lunge and a decrease of cellular immunity.They also showed a higher distribution in heary severe and extremely severe SARS.More simultaneously occurred underlying disease and complications were found in the old-aged SARS patients,which means more difficulties in the treatment of SARS and higher mortality.

Key words: SARS, old-aged, clinical features, treatment

中图分类号:

R563.1

冯明;张建;王香平;王力红;刘佑琴;魏嘉平;王育琴;张泰昌;贾强;王立;聂秀红;杨强;李宗信;王克杰;续大田;李坤成;尹建国;韩玫;徐玲;丁秀娟. 41例老年严重急性呼吸综合征患者的临床特点和治疗分析[J]. 首都医科大学学报, 2003, 24(4): 380-384.

Feng Ming;Zhang Jian;Wang Xiangping;Wang Lihong;Liu Youqin;Wei Jiaping;Wang Yuqin;Zhang Taichang;Jia Qiang;Wang Li;Nie Xiuhong;Yang Qiang;Li Zongxin;Wang Kejie;Xu Datian;Li Kuncheng;Yin Jianguo;Han Mei;Xu Ling;Ding Xiujuan. Clinical Characteristics and Therapeutic Analysis of 41 Old-Aged SARS Patients[J]. Journal of Capital Medical University, 2003, 24(4): 380-384.

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