严重急性呼吸综合征患者肺部残留病变CT远期随访研究  

Long-term follow-up study for the remaining lesions of lungs in patients with SARS

作　　者：刘长柱[1] 程国英[1] 冯元博[1] 刘月[1] 华琳[2] 彭堃[3] 

机构地区：[1]北京市第六医院放射科,100007 [2]首都医科大学生物医学工程学院数学教研室 [3]北京市第六医院呼吸内科,100007

出　　处：《中华放射学杂志》2005年第12期1277-1280,共4页Chinese Journal of Radiology

摘　　要：目的探讨严重急性呼吸综合征(SARS)患者肺部残留病变CT远期动态变化特点及相关残留因素分析。方法随访50例SARS患者(男16例,女34例),分别于发病后3、6、9、14、24个月行螺旋CT常规扫描和高分辨率扫描。结果(1)3个月随访显示24例肺内残留病变基本吸收,6个月吸收30例,14个月35例,24个月37例,仍有13例肺内残留病变,其中磨玻璃样病灶8例,细网状影4例,索条影6例,胸膜下弧形影2例,合并牵拉性支气管扩张2例。(2)回顾性对比3个月肺内病灶残留组与吸收组患者发病不同时期(3～21d)胸部影像特点,显示在病灶大小及进展方面差异有统计学意义(P<0.05)。(3)比较2个年龄组(≥40岁24例,<40岁26例)随访不同阶段肺内病灶残留率,差异均有统计学意义(P值均<0.05)。结论26%(13/50)SARS患者于24个月随访仍可见肺内病变残留,病灶仍以磨玻璃样病灶为主(8/13),并伴有肺间质增生及纤维化;年龄≥40岁的患者,肺内易残留病变。Objective To study the dynamic CT features of severe acute respiratory syndrome （SARS） in recovery phase, and to analyze the correlative remaining factors on CT images. Methods Total 50 patients with SARS were followed-up with chest spiral CT and HRCT in 3, 6, 9, 14, 24 months after onset. Results （ 1 ） The pulmonary lesions were completely absorbed in 24 cases in 3 months, 30 cases in 6 months and 37 cases in 24 months. Abnormal CT findings were showed in 13 patients later, which appeared ground-glass opacity 8,irregular lines 6, thickening of interlobular septa 4, subpleural lines 2 and bronchiectasis 2. （2）Reviewing the lesions on CT between the remained group in the third month and the absorption group, there was a difference in the extent and the progress of the lesions . （ 3 ） There was a difference of the appearance rate of remaining lesion in lungs in two groups （ ≥40 ages and 〈 40 ages ）. Conclusion （ 1 ） Residual lesions were found in 26.0% patients with SARS in 24 months after onset , which appeared mainly as the ground-glass lesions with pulmonary interstitial hyperplasia and fibrosis. （2）If the progress was rapid and long, the extent of lesions was extensive and ages was more than 40 in their suffering stage, the pulmonary lesions would be remained frequently.

关 键 词：严重急性呼吸综合征 体层摄影术 X线计算机 随访研究 

分 类 号：R511.9[医药卫生—内科学] R816.4[医药卫生—临床医学]