Abstract: The objective was to discuss clinical features treatment and outcome of severe acute respiratory syndrome(SARS).Methods:Clinical data of220probable SARSpatients admitted from Jun.27,2003to May.6,2003 in Xuanwu Hospital was analyzed retrospectively.Result:220 probable SARSpatients were aged from 7to 86 years(averaged41.33±18.40),among them112were males(50.9%)and108females(49.1%).33cases were medical staffs(15.0%).148 cases had clear contact history(67.3%).60cases(27.3%)had underlying diseases.Clinical feature clusters were fever(218 cases,99.1%),cough(144 cases,65.5%),coldness(64 cases,29.1%),breathlessness(91 cases,41.4%),chest discomfortness(80 cases,36.4%)and myalgia(66 cases,30%).Lymphopenia and normal or decreased blood white cell count were found in the early stage,while T cell subgroups(CD₃,CD₄ and CD₈ )dropped continually along with the development of the course of SARS.Chest file or high resolution CT showed monolateral or bilateral localized mottling infiltration,and polymorphic change increased in a short term at the start of SARS.Patchy or confluent shadows,opacities or enlarged size of consolidation could be seen at fastigium.Among the analyzable blood gas analysis in 145 cases,hypoxeamia were found in 63 cases(43.4%),and25of them developed into ARDS(11.4%).Assisted ventilation was carried out on 31 cases(14.1%).201cases were clinically cured and discharged,and only 19 cases died(8.64%).Early oxygen administration by nasal cannulae,proper corticosteroid administration and assisted ventilation during evolutional stage could hold back the developing course of SARS.Rational and proper use of antibiotics and antifungals can prevent and treat combined infection(bacterial and fungal).Conclusion:Epidemic contact history,fever,normal-to-low leucocytes count,lymphopenia and infiltrate changes on chest X-ray or CT are the evidence of clinical diagnosis.Age,underlying disease,the extent of lung pathological changes,hypoxaemia,the absolute value drop in Tcell subgroups(CD₃,CD₄ and CD₈ ),corticosteroids dosage and combined infection are important factors for the prognosis of SARS.The rational and normal use of corticosteroids and antibacterials,proper use of assisted ventilation are significant to the decrease of SARS mortality.

Key words: SARS, diagnosis, treatmeat