Pooled-analysis on clinical features of human infection with severe acute respiratory syndrome

分析SARS的临床特征，为SARS的诊疗技术和疾病监测的完善提供循证依据。方法以规定检索词在常用中、英文数据库中检索并严格按照纳入与排除的标准纳入文献。将纳入文献的研究病例汇集后分析患者症状、体征、常见实验室检查、影像学改变及其并发症等临床特征发生的概率。结果经过严格筛选共纳入文献93篇，其中英文文献19篇，中文文献74篇，汇集研究病例5116例。SARS患者的症状主要涉及全身症状和呼吸系统症状，部分患者也可有消化系统症状。SARS患者主要症状包括：发热4782例(93.47％)、咳嗽3023例(59.09％)、畏寒2822例(55.16％)、全身不适2257例(43.53％)和肌肉酸痛2165例(42.32％)。主要体征为呼吸频率增快1197例(23.40％)。血常规检查主要表现为：淋巴细胞计数降低，外周血白细胞计数正常或降低。影像学表现以磨玻璃密度影和肺实变影为主。结论加强临床医生对SARS患者非呼吸系统的临床表现的认识，可提高对SARS病例早期筛查的准确性。Objective To analyse the clinical features of the severe acute respiratory syndrome( SARS) , provide the evidence-based basis for its treatment technology and disease surveillance. Methods To search in Chinese and English database with formulary search terms, identify articles according to the inclusion and exclusion criteria, put all observations together into frequency analyses of patients symptoms, signs, common laboratory tests and complications. Results 93 articles were included, of 74 papers in Chinese, 19 in English, pooled analysis with 5116 cases. SARS manifestation mainly related to body and respiratory symptoms, some patients might also have digestive symptoms. The main symptoms of SARS were fever 4782 cases(93.47％ ), cough 3023 cases(59.09％ ), chills 2822 cases(55.16％ ),malaise 2257 cases(43.53％), myalgia 2165 cases(43.32％). The main sign was high respiratory rate in 1197 cases (23.40％). The main laboratory tests included lymphocyte count decreased, WBC showed normal or reduced. The main image changes were ground-glass density shadow and pumonary opacities. Conclusions To enhance the awareness of clinical manifestations of the non-respiratory system in SARLS can increase the accuracy of eady screening.国家863计划中国科技核心期刊(ISTIC)04225-2283