Wang Jann-Tay, Chang Shan-Chwen
Division of Infectious Diseases, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Curr Opin Infect Dis. 2004 Apr;17(2):143-8. doi: 10.1097/00001432-200404000-00013.
Severe acute respiratory syndrome (SARS) is an infectious disease first recognized in November 2002 in Guangdong Province, China. It spread to many countries all over the world during February to June 2003, with 8098 cases reported. Twenty-one percent of the affected people were health care workers. Because SARS is a new emerging disease, this review describes the current understanding about the etiology, clinical pictures, laboratory and radiological findings of SARS.
Severe acute respiratory syndrome-associated coronavirus (SARS-CoV) was quickly found to be the etiological agent of SARS in April 2003. The transmission of SARS-CoV between human beings is mainly due to close contact. Using barrier precautions, the transmission of SARS-CoV can be prevented. The most common clinical presentations of patients with SARS include fever, cough, and dyspnea. The common laboratory findings include lymphopenia, thrombocytopenia, elevated serum alanine and aspartate aminotransferase, lactate dehydrogenase, creatine phosphokinase, and C-reactive protein. The most common radiological finding is pneumonic lesion(s) in the chest radiogram. Many patients experience exacerbation of clinical symptoms in the second week of disease course and some may progress to respiratory failure and need mechanical ventilatory support. The overall case fatality rate is 9.6%. The current method of treatment of SARS is still controversial.
SARS is an infectious disease with high contagiousness and a high mortality rate. Early case identification and infection control are two important factors to limit its spread.
严重急性呼吸综合征(SARS)是一种于2002年11月在中国广东省首次被识别的传染病。2003年2月至6月期间,它传播到了全球许多国家,报告病例达8098例。21%的感染者为医护人员。由于SARS是一种新出现的疾病,本综述描述了目前对SARS病因、临床表现、实验室及影像学检查结果的认识。
2003年4月很快发现严重急性呼吸综合征相关冠状病毒(SARS-CoV)是SARS的病原体。SARS-CoV在人与人之间的传播主要是由于密切接触。采取屏障预防措施可预防SARS-CoV的传播。SARS患者最常见的临床表现包括发热、咳嗽和呼吸困难。常见的实验室检查结果包括淋巴细胞减少、血小板减少、血清丙氨酸和天冬氨酸转氨酶、乳酸脱氢酶、肌酸磷酸激酶及C反应蛋白升高。最常见的影像学表现是胸部X线片上的肺部病变。许多患者在病程第二周出现临床症状加重,部分患者可能进展为呼吸衰竭,需要机械通气支持。总体病死率为9.6%。目前SARS的治疗方法仍存在争议。
SARS是一种具有高传染性和高死亡率的传染病。早期病例识别和感染控制是限制其传播的两个重要因素。