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目的探讨重型传染性非典型肺炎(AP,SARS)的临床和T淋巴细胞亚群分析.方法对我院2003年2月9日～2003年5月15日住院的重型SARS患者的临床和实验室资料进行总结.结果22例重型SARS患者,平均年龄(36.6±23.2)岁,部分合并基础疾病,发热100%,咳嗽91%,呼吸困难100%,胸闷82%,胸痛41%;中性粒细胞比例升高95%,淋巴细胞比例降低95%;心肌酶谱升高86%,肝功能异常73%,肾功能损害9%;CD4+T细胞计数(12.6±4.5)%,CD8+T细胞计数(19.6±8.9)%,CD3+T细胞计数(46.0±15.1)%,与正常人和普通SARS患者比较,CD4+T、CD8+T、CD3+T均降低,差异有显著性意义(P＜0.01).胸片大片状阴影22例(100%),病变范围48 h超过50%为63.6%,肺实变100%,肺不张23%,肺纤维化82%.使用激素治疗22例,日达仙治疗7例,无创呼吸机通气7例,气管插管或气管切开2例,治愈或好转19例,转院治疗2例.平均发热时间(20±10)d,平均住院时间(42±24)d,胸片开始吸收好转时间(14±6)d.结论重型SARS年龄较大,部分患者合并基础疾病,中性粒细胞显著降低,淋巴细胞比例和绝对数显著下降,细胞免疫功能显著降低,心肌酶谱显著升高,动脉氧分压显著降低,肺部病灶发展快,病变重,吸收慢,多合并肺纤维化.早期使用大剂量激素联合利巴韦林可能对病情减轻有帮助.“,”Objective: To study the clinical and T lymphocyte subpopulation analysis of the patients with severe acute respiratory syndrome (SARS) of heavy type. Methods: summarized the clinical and laboratory feature of 22 patients with severe acute respiratory syndrome (SARS) of heavy type hospitalized in Shenzhen East Lake hospital from Feb 9th 2003 to May 25th 2003. Results: Among 22 cases with heavy SARS, the average age was (36.6 ± 23.2) years old; the most common symptoms included fever (100%), cough (91%), dyspnea (100%), chest stress (82%), chest pain (41%); the most common laboratory findings included lymphopenia (95%), granulocytosis (95%) ,elevated amino - transaferase and lactate dehydrogenase level (73%, 86% respectively), the mean of CD4+ T, CD8+ T, CD3+ T cell count decreased [(12.6 ± 4.5)%, (19.6 ± 8.9)%, (46.0±5. 1)% , respectively], and the differences were significant in statistics(P ＜0.01 ); the most common chest X ray features included bilateral interstitial pneumonia( 100% ), a large patchy shadow ( 100% ), dramatic development and quick movement in lung opacity less than 48 hours pulmonary fibrosis 18 (82%), pulmonary consolidation ( 100% ). 22 cases were treated with corticosteroids and ribavirin, 7 patients with α - 1. thymocin, 7 cases with no trauma mechanical vetilation, 2cases with endotrachael intubation operation or tracheostomy, 19 cases cured or recovered, 2 transferred to other hospitals, the time of the chest radiography absorption was (14 ± 6) days, the average hospitalized time was (42± 24) days, the average time of fever (20 ± 10) days, and 20 cases who have been treated effectively, in our hospital, 2 cases had been transferred to other hospital. Conclusions:The neutrophilic granulocyte cells of SARS patients increased significantly, and lymphocyte cells absolute or relative count and cellular immune mediate function decreased significantly. Pulmonary lesions were serious and developed quickly, but absorbed slowly, pulmonary fibrosis was very common. It would be very effective in most patients if Corcosteriods and Ribavirin to be used early.