[Clinical analysis of SARS: 27 cases report].
OBJECTIVE
To realize the clinical characteristic of severe acute respiratory syndrome (SARS).


METHODS
Observe the clinical signs and symptoms of each patients; do laboratory examination periodically; and at last do Stat analysis of all the cases.


RESULTS
The first onset symptom of the 27 cases is high fever accompany with toxic symptom such as muscular soreness, headache, etc. The patient's condition may be most serious in the 2nd week. The amount of end-brush blood WBC decrease, especially the lymphocyte decrease more obviously. The amount of CD(4)(+) and CD(8)(+) decrease obviously is another important characteristic. The chest X-ray show pulmonary lesion in the 2nd day after onset of the illness, but 40.7% cases show positive change after 6 days onset. During the 7 - 12 days the pulmonary lesion become most serious. Seven cases are treated by steroid in the first 3 days when the chest X-ray is normal, but they become positive during 6 - 8 days of the course. Whether the state of the illness is serious or not seems no obvious relationship to when they are treated by steroid. And large dosage of steroid may inhibit the level of CD(4)(+) and CD8 (P < 0.05). Two severe cases present double infection after large dosage of steroid.


CONCLUSIONS
The course of a infectious atypical pneumonia is almost 3 weeks, the 1st week can be decided as early stage, the 2nd week is decided as fastigium, the 3rd week is decided as stage of recovery. During the fastigium, the disease transform very quickly, we need pay more attention to the patient. The CD(4)(+), CD(8)(+) and CD(3)(+) of SARS patient decrease obviously, it seems the immuno-function inhibited seriously. The serious case is easily accompany with severe secondary infection in the late stage, so the use of steroid must be carefully and the dosage need not to be much more.
Li
Xing-wang
XW
Beijing Di-tan Hospital, Beijing 100011, China.
Jiang
Rong-meng
RM
Guo
Jia-zhen
JZ
Wang
Qing-yue
QY
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D045169:Severe Acute Respiratory Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology
D000305:Adrenal Cortex Hormones