SARS患者康复期肺功能的变化  

Changes in pulmonary function in severe acute respiratory syndrome patients 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] 郑劲平[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,510120

出　　处：《中国危重病急救医学》2005年第6期329-331,共3页Chinese Critical Care Medicine

基　　金：国家"863"计划项目(2003AA208107);广东省卫生厅课题(A2004274)

摘　　要：目的了解严重急性呼吸综合征(SARS)患者康复期肺功能的特征性及其变化规律。方法对26例SARS患者出院后每隔3个月进行1次肺功能检查,分析康复期肺功能各指标的意义。结果SARS患者发病后第3～6个月肺功能主要表现为限制性通气功能障碍和弥散功能障碍。不同时间段(3～6个月、6～9个月、9～12个月、12～15个月、15～17个月)的用力肺活量(FVC)、1秒用力呼气容积(FEV1.0)、功能残气量(FRC)和残气容积(RV)差异均无显著性,但随康复时间的延长而逐渐增加;同时FEV1.0/FVC变化不大;而肺总量(TLC)和肺一氧化碳弥散量(DLCO)在不同时间段均有不同程度的好转。结论SARS患者发病后肺功能的损害主要表现为限制性通气功能障碍和弥散功能障碍,但随康复时间的延长两者均逐渐恢复。Objective To investigate the changes and pattern of pulmonary function in severe acute respiratory syndrome (SARS) patients during convalescent period. Methods Pulmonary function tests were performed in 26 SARS convalescent patients regularly every 3 months after their discharge from hospital. The significance of changes in pulmonary function indexes was analyzed. Results Restrictive pulmonary ventilation function and diffusing dysfunction of the lung were found in one third of the patients during third to sixth month from onset. There was a little improvement in forced vital capacity (FVC), one second forced expiratory volume (FEV_ 1.0 ), functional residual capacity (FRC) and residual volume (RV) as convalescent period was prolonged, but no difference was found betweendifferent stages (36 months, 69 months, 912 months , 1215 months and 1517 months). Meanwhile, the FEV_ 1.0 /FVC showed no significant change. However, there was an obvious improvement in total lung capacity (TLC) and diffusing capacity of the lung for carbon monoxide (DLCO) with the elapse of time, and also a significant difference was found betweenthe later stage and the earlier stage. Conclusion Pulmonary dysfunction is found among some SARS patients after convalescence presenting mainly as restrictive ventilatory function and diffusing capacity abnormality. These dysfunctions would improve gradually with the elapse of time.

关 键 词：患者康复期 严重急性呼吸综合征(SARS) 限制性通气功能障碍 SARS患者 肺一氧化碳弥散量 弥散功能障碍 用力呼气容积 FEV1.0 主要表现 康复时间 肺功能检查 用力肺活量 功能残气量 变化规律 残气容积 不同程度 发病后 时间段 

分 类 号：R511.9[医药卫生—内科学]