SARS患者心脏、肾脏等肺外器官损害及其临床意义——附330例临床研究.docVIP

　　SARS患者心脏、肾脏等肺外器官损害及其临床意义——附330例临床研究 --　　 [摘要] 目的:分析严重急性呼吸综合征(SARS)患者心脏、肾脏等肺外器官的损害及外周血象变化特点,并探讨其临床意义。方法:回顾性总结330例临床确诊的SARS患者心脏、肾脏损害及外周血象变化特点,采用SPSS11.0及SDAS软件进行统计分析。结果:(1)SARS轻型患者心脏损害多在1周内出现,LDH、HBDH、CK、CK-MB复常率分别为74.2%、80.6%、100%和100%;重型患者心脏受损常出现在1周后,上述心肌酶复常率分别为32.2%、29.5%、55.2%和44.4%,均显著低于轻型患者,其中10例CK-MB未恢复者全部死亡。(2)54.2%的患者平均在发病1周(1~10 d)内出现尿红细胞,轻型患者平均在12.5(4~21) d时完全恢复正常,重型有18.4%不能完全恢复,两者差异显著(P 　　[关键词] 严重急性呼吸综合征 心脏 肾 外周血 Damage to non-pulmonary organs like heart and kidney in SARS patients:An analysis of 330 cases [ABSTRACT] Objective:To analyze the features and clinical significance of damages to non-pulmonary organs like theheart,kidney and peripheral blood in SARS patients.Methods:SPSS 11.0 and SDAS softages to the heart,kidney and peripheral blood in 330 clinically confirmed SARS cases.Results:(1)The heart damage occurred ild cases; the rates of LDH,HBDH,CK and CK-MB return-ing to normal age usually occurred 1 al al died.(2) The changes of RBC count appeared after an aver-age of 1 al in all the mild SARS cases after an average of 12.5(4-21) d but didnot in 18.4% of the severe cases (P 　　The decrease of platelet count mainly occurred in severe cases (40.0%) and usually appeared 2 al level in only 43.9% of the patients.Conclusion:The non-pulmonary organ damages in SARS patients arecharacterized by co-existence of primary and secondary damages.The heart damages usually occur at the advanced stage due todirect toxic effects of SARS virus and hypoxemia.Renal damage mainly appears at the stage of viremia,and it mainly manifestsas azotemian in severe cases.The changes of lymphocyte count can reflect the severity of SARS.The decrease of platelet countis secondary and its progression suggests --perniciousness of the disease condition. 　　[KEY B、血糖(Glu)、尿素(urea)、肌酐(Cr)均采用Olympus AU-600全自动生化分析仪检测,外周血细胞常规分析在SYSCMEXK4500(日本)全自动血细胞分析仪进行。 　　1.3 统计学处理 使用SPSS 11.0及SDAS软件进行统计分析。 　　2 结 果 2.1 心脏损害情况 见表1。 SARS轻型患者心脏受到损害平均在1周以内,LDH、HBDH、CK、CK-MB复常率分别为74.2%、80.6%、100%和100%,而重