康复期传染性非典型肺炎患者肺一氧化碳的弥散能力  

Diffusing capacity of the lung for carbon monoxide in patients with severe acute respiratory syndrome at convalescence

作　　者：陈天狮[1] 陈良安[1] 解立新[1] 刘又宁[1] 郝凤英[1] 田庆[1] 范保星[1] 

机构地区：[1]解放军总医院呼吸科,北京市100853

出　　处：《中国临床康复》2005年第23期98-100,共3页Chinese Journal of Clinical Rehabilitation

基　　金：国家高技术研究发展计划课题(2003AA208107)~~

摘　　要：目的:对影响康复期传染性非典型肺炎患者肺一氧化碳弥散能力的因素进行计数和计量资料分析,观察性别、年龄、激素用量以及复检时特异性IgG抗体阳性与肺一氧化碳弥散能力的关系。方法:①选择2003-07/08在解放军总医院呼吸内科传染性非典型肺炎随访门诊复诊的北京地区传染性非典型肺炎康复期患者208例,男79例,女129例。均已签署知情同意书。②根据肺一氧化碳弥散能力的结果将传染性非典型肺炎康复期患者分为肺一氧化碳弥散能力正常组115例(肺一氧化碳弥散能力以≥80%预计值)和肺一氧化碳弥散能力异常组53例(肺一氧化碳弥散能力以<80%预计值)。③每例复诊的康复者均进行常规肺功能和传染性非典型肺炎冠状病毒特异性IgG抗体检查。首次就诊后1个月左右再次复诊,2次复诊时间间隔28～47d,平均(35±6)d。④传染性非典型肺炎冠状病毒特异性IgG抗体检查应用酶标记免疫吸附测定法进行检测。⑤记录患者的一般资料(如性别、年龄)和肺一氧化碳弥散能力(异常或正常),并收集患病期间应用糖皮质激素用量数据(激素用量均换算为甲基强地松龙的累计用量)。⑥IgG抗体检测时,样本置酶标仪450nm波长下测定吸光度(A)值。阴、阳性对照和被检样本的A值即为计算值.临界值=0.11+阴性对照A均值,被检样本的A值大于临界值判为传染性非典型肺炎冠状病毒抗体IgG阳性反应。⑦计量和计数资料差异性测定采用t检验和χ2检验。以肺一氧化碳弥散能力结果为因变量,传染性非典型肺炎冠状病毒特异性IgG抗体检测的A值、性别、年龄和糖皮质激素用量等为自变量进行单因素分析;采用后退法,以pe(0.05)和pr(0.06)标准对上述自变量进行逐步logistic回归建立较为优化的回归方程。结果:传染性非典型肺炎康复期患者208例均进入结果分析。①女性所占比例、应用激素例数比例、激AIM: To count and measure the factors, which can affect the diffusing capacity of the lung for carbon monoxide in patients with severe acute respiratory syndrome at convalescence, and observe the association of gender, age, amount of hormone usage and positive specific immunoglobulin G antibody at reexamination with the diffusing capacity of the lung for carbon monoxide. METHODS: ① Totally 208 patients (79 males and 129 females) with severe acute respiratory syndrome at convalescence, who were reexamined in the follow-up clinic of severe acute respiratory syndrome, Department of Respiratory Medicine, General Hospital of Chinese PLA between July and August 2003, were all agreed to participate in this study. ② According to the results of the diffusing capacity of the lung for carbon monoxide, the patients were divided into normal group (n=115, the diffusing capacity of the lung for carbon monoxide ≥ 80% of the predicted value) and abnormal group (n=53, the diffusing capacity of the lung for carbon monoxide < 80% of the predicted value).③ Every reexamined convalescent patients received examinations of routine pulmonary function and severe acute respiratory syndrome coronary virus specific immunoglobulin G antibody, and they were examined again at about 1 month after the first treatment, the interval between the two reexaminations was 28 to 47 days with an average of (35 ±6) days.④The severe acute respiratory syndrome coronary virus specific immunoglobulin G antibody was detected with enzyme-labelling immunosorbent assay. ⑤ The general information (gender and age) and the diffusing capacity of the lung for carbon monoxide (normal or abnormal) of the patients were recorded, and the data for the amount of glucocorticoid usage, which was converted to the added usage amount of Medrol during the treatment were collected.⑥ For the detection of immunoglobulin G antibody, the absorbance (A value) was detected under the enzyme-labelling meter with the wave length of 450nm. The A values of the positive and negat

关 键 词：严重急性呼吸综合征 肺弥散能力 糖皮质激素类 

分 类 号：R563[医药卫生—呼吸系统]