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2例SARS患者实验室指标动态观察及其与临床的关系
作者:王念跃 赵伟 潘淮宁 吴引伟 刘伟 周镇先 
单位:东南大学医学院,附属南京第二医院,江苏,南京,210003
关键词:严重急性呼吸综合征 冠状病毒/诊断 病例报告 
分类号:R563.19, R563.8, R511
出版年·卷·期(页码):2004·23·第一期(42-44)
摘要:

目的:动态观察2例严重急性呼吸综合征(SARS)患者实验室指标的变化,探讨其变化特点以及在评估SARS病情发展变化中的价值.方法:在发病过程中抽取静脉血进行血常规、血生化指标以及T淋巴细胞亚群以及其他感染性指标的检测.结果:2例SARS患者外周血白细胞计数入院后合并感染时出现过升高,后经治疗转为正常;嗜酸粒细胞变化符合急性传染病的变化规律,可用该指标判断预后;CD3+、CD4+、CD8+T淋巴细胞入院时均显著降低,并随病情好转而升高;血清生化指标中,入院时肝酶谱、心肌酶谱增高;冠状病毒变异株抗体在病程中出现,且IgM略早于IgG 1~2d出现.结论:CD3+、CD4+、CD8+T淋巴细胞及淋巴细胞比例,可能是反映SARS患者病情严重程度的重要指标,对其动态观察对SARS患者的病情发展、疗效观察及预后判断等方面具有非常重要的指导价值.冠状病毒变异株抗体对回顾性诊断有意义.

Objective   The changes of laboratory data in 2 patients with severe acute respiratory (SARS) were observed and their characteristics were also assessed in the value of development.Methods   The blood routine,biochemical test,T lymphocell subgroup as well as other infection marking in peripheral vein blood were detected in disease course.Results  White blood cell amount of SARS patients have taken on going up after hospitalizing,and returned to normal step by step with treatment.Multinomial biochemical data increased.CD3  +-CD4  +-CD8  + T lymphocell notably reduced,and went up with condition improvement of patients.The antibody of coronavirus in the blood was not shown up until 11th~14th day after onset of illness.Conclusion  CD3  +-CD4  +-CD8  + T lymphocell and lymphocell proportion were important laboratory data of SARS patient whose condition is  serious,and have very vital guidance value for treatment and prognosis judgement.The antibody of the coronavirus is meaningful for retrospectively diagnosis.

参考文献:

[1] Peiris J, LAI S, POON L. Coronavirus as a possible cause of severe acute respiratory syndrome. 2003(9368). doi:10.1016/S0140-6736(3)13077-2
[2] Lee N, HUI D, Wu A. A major outbreak of severe acute respiratory syndrome in Hong Kong. 2003(20). doi:10.1056/NEJMoa030685
[3] 朱立华, 王建中. 中国人血液淋巴细胞免疫表型参考值调查. 中华医学检验杂志1998(4)
[4] 寇丽筠. 临床基础检验学, 1989
[5] 邱海波, 郑瑞强, 赵伟. SARS患者2例的诊断与治疗. 东南大学学报(医学版)2003(4). doi:10.3969/j.issn.1671-6264.2003.04.001 

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