严重急性呼吸综合征患者康复期肺功能评价  

Assessment of pulmonary function in severe acute respiratory syndrome patients during the convalescent period

作　　者：郭尚德[1] 贺正一[1] 焦蕴敏[1] 刘颖[1] 邢军[1] 阴赪宏[1] 马大庆[1] 王宝恩[1] 

机构地区：[1]首都医科大学附属北京友谊医院

出　　处：《中国呼吸与危重监护杂志》2005年第1期23-26,共4页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：北京市科技战线重大项目(H020920050230)

摘　　要：目的研究严重急性呼吸综合征(SARS)患者康复期的肺功能动态变化状态。方法对68例康复期SARS患者在出院1、2、3及6个月进行随访,了解其症状、体征和基础疾病,测定肺功能、T淋巴细胞亚群、SARS病毒抗体IgG、血气分析,作胸部高分辨CT。对肺功能各项指标与其他指标作相关性分析。结果所有患者的SARS病毒抗体IgG为阳性。出院1个月时44例有肺功能异常(674%),43例为轻、中度异常(632%),41例有弥散障碍(603%),其中单纯弥散障碍31例(456%),6个月后仍有16例(235%)存在弥散障碍。出院3个月的TLCO较出院1个月明显好转(P<005),出院3个月与6个月的TLCO差异无显著性(P>005)。出院1个月的患者中有35例(515%)胸部CT表现异常,出院3个月的CT变化较出院1个月明显好转(P<005),出院3个月与6个月时的CT变化无显著性差异(P>005)。多元逐步回归分析显示,TLCO与CT异常改变有明显相关性。结论SARS患者康复早期存在不同程度的肺功能损害,但多数为轻、中度异常,肺功能损害以弥散下降为主。出院3个月肺功能明显好转,出院6个月与出院3个月比较肺功能改善无明显差异。Objective To investigate the pulmonary function in severe acute respiratory syndrome (SARS) patients during the convalescent period.Methods 68 patients of SARS were followed up for 6 months.The follow-up projects consisted of interview,physical examination,pulmonary function test,thoracic CT scanning,T lymphocyte subsets counts,SARS CoV antibody assay and blood gas analysis.The pulmonary function was tested 1,2,3 and 6 months after discharge.Results Mild to moderate abnormalities in pulmonary function were found in 44 patients (67.4%).31 patients (45.6%) had reduction of diffusion capacity for carbon monoxide (T_~LCO )in the first follow-up and 16 patients (23.5%) had that in the last follow-up.T_~LCO at the first follow-up was significantly different from that at 3 months after discharge,but no signicant difference was found between 3 months and 6 months after discharge.Multiple regression indicated that thoracic CT manifestations was significantly correlated to T_~LCO .Conclusions T_~LCO impairment is the primary pulmonary disturbance in convalescent SARS patients.Pulmonary function might improve gradually by 3 months after discharge.However,little improvement of lung function is found from 3 months to 6 months after discharge.

关 键 词：出院 肺功能损害 SARS患者 康复期 SARS病毒抗体 中度 CT 严重急性呼吸综合征 弥散 基础疾病 

分 类 号：R511.9[医药卫生—内科学]