首都医科大学学报 ›› 2003, Vol. 24 ›› Issue (4): 460-463.

• 论著·临床研究 • 上一篇    下一篇

15例住院少年儿童严重急性呼吸综合征患者的回顾分析与思考

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

  1. 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

Analysis of Respiratory Infection in 15 Hospitalized Child Patients in May 2003

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

  1. 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: 我院收治的220例严重急性呼吸综合征(SARS)患者中15例为18岁以下的少年儿童。其中男10例,女5例,年龄7岁1例,8~14岁4例,15~18岁10例,平均年龄15.1岁,占总住院病人数的6.8%。按SARS临床诊断标准,重新回顾15例少年儿童患者的流行病学史、临床症状、实验室检查、胸部X线、抗生素治疗反应等5个方面。认为对少年儿童患者的临床诊断,最为重要的条件是1)与SARS患者的密切接触史;2)家庭和群体聚集发病。为避免诊断的扩大化,要明确界定“疫区”和“区域”的概念。胸部X线阴影是SARS诊断依据,早期使用CT检查,可提供明确的影像诊断依据。实验室检查和对抗生素治疗反应,可提供参考。二者与典型肺炎相比,无明显差异。对少年儿童SARS患者的治疗,慎用激素,以避免激素引起的不良作用。少儿SARS患者病情较轻,减少使用贵重的其他免疫制剂,可降低SARS治疗的医药费用。少儿SARS发病率低,其原因有待于病原学的深入研究。在部分婴幼儿和少年儿童血清中,存在SARS病毒的抗体。SARS病毒和其他病毒之间存在着交叉免疫;因此,在病毒病原学的免疫检查中,需要一个金标准。

关键词: 严重急性呼吸综合征(SARS), 青少年儿童

Abstract: In May 2003,220 patients diagnosed as SARS in other hospitals were transferred to XUANWU hospital.Fifteen cases(female 5)were under of 18 years old.The youngest patient was7years old.Four patients were from8to14years old.Ten patiens were between the age of 15 and 18 years old.The average age was 15.1years old.Based on the Guanzhou diagnostic criteria of SARS,the epidemic history,clinical symptoms,laboratory tests,the results of chest X-ray,and their response to antibiotic administration points.The most important were reviewed for correct diagnosis of SARS in children were①close contact to SARSpatients;②family or group history.In order to avoid the over misdiagnosis of SARS,differentiation of the"epidemic area"from the"local region"must be made correctly.The shadow in chest X-ray examination is an important point.It is necessary for patiens to have an early CTscan for SARS diagnosis.Laboratory test and the response to antibiotics of these patients are also referential to make a correct diagnosis.These two aspects are similar to typical pneumonia.In order to reduce the adverse effects of corticosteroid,careful use of corticosteroid in the treatment of SARS are recommended.The condition of child patient with SARS is often stable,so it is not necessary to give expensive immunologic products.The reason why children are less infected by SAR Sshould be studied further using pathogenic methods.The antibody to SARS virus can be found in the serum of some babies and children.SARS virus shows some cross immuno-reaction to other viruses.Therefore,a golden criteria should be developed for the detection of pathogenic viruses.

Key words: SARS, children

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