严重急性呼吸综合征患者康复期肺部X线的转归及其影响因素  

The changes of roentgenography appearance in patients with severe acute respiratory syndrome and their affected factors during convalescent period.

作　　者：郑则广[1] 陈荣昌 吴华[1] 刘晓青[1] 何为群[1] 徐远达[1] 陈思蓓[1] 黎毅敏[1] 曾庆思[1] 钟南山[1] 

机构地区：[1]广州医学院第一附属医院广州呼吸病研究所,广州510120

出　　处：《中国实用内科杂志》2005年第4期319-321,共3页Chinese Journal of Practical Internal Medicine

基　　金：国家 863计划 (编号: 2003AA208107 );广东省卫生厅课题(编号:A2004274 );广州市科技计划项目 (编号: 2004J1 C0212)

摘　　要：目的通过对严重急性呼吸综合征(SARS)患者的跟踪观察,了解其康复期X线的特征及其影响因素.方法2003-06～2004-04对广州医学院第一附属医院52例SARS患者出院后每隔3个月进行X线检查.结果发病后第3、6个月X线正常/异常患者比分别为52/28和32/13(P=0.015);其中11例在第3、6个月和15个月表现肺纹理增粗、紊乱和网格状改变的例数分别为(11,4,5)、(9,4,4)和(6,1,1)(任两者比,P均＜0.01);急性期的病灶范围、气胸、纵隔气肿、继发下呼吸道感染、氧合指数和轻重对X线的转归有影响,而无创通气和激素没有影响,Logistic回归分析未显示危险因素.结论SARS患者康复期X线的病变表现为纹理增粗、紊乱和网状改变.这些病变均可逐渐吸收,甚至消失.Objective To investigate the changes of roentgeno gr aphy appearance in SARS patients and their affected factors during convalescent period.Methods The X-ray of lungs were performed in 52 SARS patients regularly every 3 months after their discharge from hospital.Results The cases ratio of normal/un-normal of X-ray in the 3 rd and 6 th month from onset was respectively 52/28 and 32/13(P=0 .015).The number of cases with increased bronchovascular shadows,derangement of bronchovascular shadows and reticular shadows among 11 cases in 3 rd,6 th and 15 th month were respectively (11,4,5)、(9,4,4) (compared with 3 rd,P<0.01) and (6,1,1) (compared with 3 rd and 6 th,both P <0.01).The prognosis of lung X-ray was affected by the range of shadows,the complications(pneumothorax,mediastina emphysema and secondary infections of lowe r respiratory tract),oxygenate index and the severe degree of the SARS during th e acute phrase,but not by the non-invasive ventilation or steroid.By the analys is of logistic,no dangerous factor was found in prohibiting the disappearance of shadow.Conclusion The roentgenography of SARS patients in the convales cent period shows increased bronchovascular shadows,derangement of bronchovascul ar shadows and reticular shadows which can disappear step by step.

关 键 词：X线 康复期 患者 转归 肺部 严重急性呼吸综合征 改变 比分 结论 特征 

分 类 号：R563[医药卫生—呼吸系统] R197[医药卫生—内科学]