Eight-month prospective study of 14 patients with hospital-acquired severe acute respiratory syndrome.
Eight-month prospective study of 14 patients with hospital-acquired severe acute respiratory syndrome.
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对14例医院获得严重急性呼吸综合症患者的八个月前瞻性研究。
DOI：
10.4065/79.11.1372
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发表时间：
2004-11
影响因子：
8.9
通讯作者：
Perng RP
中科院分区：
文献类型：
--
作者：
Chiang CH;Shih JF;Su WJ;Perng RP
明确医院获得性严重急性呼吸综合征（SARS）的临床特征和临床病程。这项为期 8 个月的前瞻性研究于 2003 年 4 月至 12 月对台湾台北市的 14 名医院获得性 SARS 患者进行。我们的 14 名医院获得性 SARS 患者最常见的症状是发烧、呼吸困难、头晕、不适、腹泻、干咳、肌肉疼痛和寒战。淋巴细胞减少以及乳酸脱氢酶 (LDH) 和 C 反应蛋白 (CRP) 血清水平升高是最常见的初步实验室检查结果。最初的胸片显示各种模式异常和正常结果。 14 名患者中有 5 名需要机械通气。机械通气的需要与最初的胸片显示双侧肺部受累以及 LDH 和 CRP 峰值水平较高有关。疾病的临床严重程度从轻微到严重不等。发病8个月后，轻度或中度SARS患者的胸部高分辨率计算机断层扫描结果正常或仅有局灶性纤维化。然而，4名重症SARS康复患者的双侧纤维化改变仍然存在，其中1名患者出现轻度限制性通气障碍。一名重症非典患者死亡；她年事已高，并患有其他合并症。另外五名患者的扩散能力降低。我们的医院获得性 SARS 患者的临床表现显示，非典型肺炎伴有淋巴细胞减少、血清 LDH 水平升高、临床迅速恶化以及对经验性抗生素治疗缺乏反应。 LDH 和 CRP 水平显着升高与需要机械通气支持的严重疾病相关。在接受机械通气的患者中，急性病后 6 至 8 个月肺功能仅轻度下降，这与其他原因引起的急性呼吸窘迫综合征的自然病程一致。
To define the clinical characteristics and clinical course of hospital-acquired severe acute respiratory syndrome (SARS). This 8-month prospective study of 14 patients with hospital-acquired SARS in Taipei, Taiwan, was conducted from April through December 2003. The most common presenting symptoms in our 14 patients with hospital-acquired SARS were fever, dyspnea, dizziness, malaise, diarrhea, dry cough, muscle pain, and chills. Lymphopenia and elevated serum levels of lactate dehydrogenase (LDH) and C-reactive protein (CRP) were the most common initial laboratory findings. Initial chest radiographs revealed various pattern abnormalities and normal results. Five of the 14 patients required mechanical ventilation. The need for mechanical ventilation was associated with bilateral lung involvement on the initial chest radiograph and higher peak levels of LDH and CRP. Clinical severity of disease varied from mild to severe. At 8 months after disease onset, patients with mild or moderate SARS had normal findings or only focal fibrosis on chest high-resolution computed tomography. However, bilateral fibrotic changes remained in the 4 patients who had recovered from severe SARS, 1 of whom had mild restrictive ventilatory impairment. One patient with severe SARS died; she was elderly and had other comorbidities. Five additional patients had reduced diffusing capacity. The clinical picture of our patients presenting with hospital-acquired SARS revealed atypical pneumonia associated with lymphopenia, elevated serum levels of LDH, rapid clinical deterioration, and lack of response to empirical antibiotic therapy. Substantially elevated levels of LDH and CRP correlated with severe illness requiring mechanical ventilatory support. In those receiving mechanical ventilation, pulmonary function was only mildly reduced at 6 to 8 months after acute illness, consistent with the natural history of acute respiratory distress syndrome due to other causes.
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DOI：
10.1164/rccm.200206-542oc
发表时间：
2003-03-01
影响因子：
24.7
作者：
Orme, J;Romney, JS;Weaver, LK
通讯作者：
Weaver, LK
影响因子：
7.3
作者：
Ding, YQ;Wang, HJ;Yao, KT
通讯作者：
Yao, KT
影响因子：
--
作者：
Wong, RSM;Wu, A;Sung, JJY
通讯作者：
Sung, JJY
DOI：
10.1001/jama.289.21.joc30885
发表时间：
2003-06-04
影响因子：
120.7
作者：
Booth, CM;Matukas, LM;Detsky, AS
通讯作者：
Detsky, AS
DOI：
10.1016/s0140-6736(03)13412-5
发表时间：
2003-05-24
期刊：
Lancet (London, England)
影响因子：
--
作者：
Peiris JS;Chu CM;Cheng VC;Chan KS;Hung IF;Poon LL;Law KI;Tang BS;Hon TY;Chan CS;Chan KH;Ng JS;Zheng BJ;Ng WL;Lai RW;Guan Y;Yuen KY;HKU/UCH SARS Study Group
通讯作者：
HKU/UCH SARS Study Group