摘要
目的 通过对严重急性呼吸综合征 (SARS)康复期患者进行定期临床随访 ,动态观察肺功能和肺部影像学的变化 ,了解SARS疾病的特点及预后。方法 2 5 8例SARS患者康复后 2个月内先后 2次以上进行SARS冠状病毒特异性IgG抗体、肺功能和肺部影像学检查 ,并就发病期间的治疗情况进行回顾性分析。结果 2 5 8例中有 2 0 8例SARS冠状病毒特异性IgG抗体为阳性 (80 6 % ) ,5 3例合并有肺一氧化碳弥散量 (DLCO)异常。IgG抗体阳性并DLCO异常的SARS康复者与DLCO正常的SARS康复者和IgG抗体阴性的康复者比较 ,发热病程较长 ,应用糖皮质激素剂量、接受氧疗比例和无创通气比例均较高。 5 1例DLCO异常的康复者动态肺功能复查结果 ,有 4 1例 (80 4 % )患者DLCO得到改善。 5 1例中有 4 0例肺部影像学检查有肺纤维化改变 ,1个月后再次复查有 2 2例 (5 5 % )有好转。结论 SARS康复者肺纤维化改变多发生在病情较重者 ,并在康复后一定时期内能够部分自行吸收 。
Objective To analyze the clinical characteristics and prognostic changes of rehabilitating severe acute respiratory syndrome (SARS) patients through regular lung function tests and lung imaging studies after discharge and to retrospectively analyze the treatment data of these patients Methods 258 discharged SARS patients received regular SARS Co virus IgG test,lung function test and chest X ray and/or high resolution computerized tomography(HRCT) examination at General Hospital of PLA two months after discharge,and the treatment data of these patients were retrospectively analyzed Results 80 6% patients(208 of 258 patients) were positive for SARS Co virus IgG 21 3% patients(55 of 258 patients) showed lung diffusion abnormity(D LCO<80%pred) Compared to 155 SARS Co virus IgG positive patients without lung diffusion abnormity and 50 SARS Co virus IgG negative patients,the 53 SARS Co virus IgG positive patients with lung diffusion abnormity had longer fever course,higher dosages of glucocorticoid therapy,higher percentage of oxygen therapy and non invasive ventilation 51 of the 53 patients with lung diffusion abnormity received lung function test after one month,and the results of D LCO improved in 80 4% patients(41 of 51 patients) 40 of 51 patients with lung diffusion abnormity showed lung fibrosis,and the fibrosis decreased in 55% patients(22 of 40 patients)after one month Conclusions This finding suggests that lung fibrosis caused by SARS mostly occurs in severe patients,and it can resolve spontaneously D LCO may be more sensitive than HRCT in evaluating the fibrotic changes
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2004年第3期147-150,共4页
Chinese Journal of Tuberculosis and Respiratory Diseases
基金
国家 8 63课题 ( 2 0 0 3AA2 0 810 7)
关键词
严重急性呼吸综合征
呼吸功能试验
肺纤维化
高分辨CT
Severe acute respiratory syndrome(SARS)
Respiratory function tests
Pulmonary fibrosis
High resolution computerized tomography(HRCT)
