SARS患者2年康复的临床研究  

Prospective 2 - year clinical study of patients with positive IgG - antibodies after recovering from severe acute respiratory syndrome

作　　者：阴赪宏[1] 王超[1] 文艳[1] 姜利[2] 路琴[1] 李晶铃[1] 王婧[1] 贺正一[1] 张淑文[1] 王宝恩[1] 

机构地区：[1]首都医科大学附属北京友谊医院,100050 [2]首都医科大学附属复兴医院

出　　处：《中国危重病急救医学》2005年第12期740-742,共3页Chinese Critical Care Medicine

基　　金：北京市科技计划重大项目(H020920050230)

摘　　要：目的 通过对20例严重急性呼吸综合征(SARS)-IgG阳性患者2年康复的前瞻性临床研究, 探讨SARS发展规律。方法 选择20例临床确诊SARS的患者,分别于患者出院后1个月、3个月、半年和 2年观察SARS-IgG、T细胞亚群、肺功能、胸部CT等的动态变化。结果 20例患者出院后2年内, SARS-IgG水平随着时间的延长逐渐下降,但下降趋势较缓;至第2次复查时绝大部分患者的T细胞亚群恢 复至正常水平;首次复查时,胸部CT异常率为65％,主要有磨玻璃样密度病灶、小叶内间质增厚或小叶间隔 增厚、不规则的纤维索条影、胸膜下弧线影、牵拉性细支气管扩张、蜂窝状阴影等,至第4次复查时,胸部CT 的异常率仍为30％;首次复查时,肺功能以弥散常数(KCO)异常发生率最高,伴有第1秒用力肺活量(FEV1)、 一氧化碳弥散量(DLCO))的异常,至第3次复查时逐渐恢复。结论 SARS患者SARS-IgG水平下降缓慢,可 能持续较长时间;胸部CT恢复需较长时间;肺功能以弥散功能障碍为主,恢复较快。进一步进行SARS相关 指标的研究很有必要。Objective To investigate the clinical characteristics of patients recovering from severe acute respiratory syndrome （SARS） during 2 years after the infection. Methods The antibody of SARS-IgG, T cell subsets, chest CT, and the pulmonary function were observed in patients 1 month, 3 months, 6 months, and 2 years after convalescence from SARS. Results In the 20 SARS cases, the level of antibodies was found to descend gradually and slowly during 2 years after convalescence. In the majority of patients T cell subsets recovered completely to normal range at the second examination. At the first reexamination, the rate of abnormal chest CT was 65%, and the main abnormal images included ground glass opacities, thickening of inter-lobular and intra-lobular septa, distorted lobular structure, thickened bronchovascular bundles, thickened pleura, arc shadow under the pleura, bronchiolar dilation, and honey comb like shadows. The rate of abnormal chest CT was 30% at the fourth examination. At the first re-examination, the abnormal rate of Kco was highest, accompanied by abnormalities of forced expiratory volume in 1 second （FEV1） and the diffusing capacity of the lung for carbon monoxide （DLCO）, and it began to recover since the third examination. Conclusion The level of SARS-IgG descends slowly, and it may last for a long time. The recovery of chest CT to normal may take a long time. The abnormality in pulmonary functions manifests mainly as impairment of diffusion function. Further research on SARS is necessary.

关 键 词：严重急性呼吸综合征 IgG阳性 康复期 CT 肺功能 SARS 

分 类 号：R511.9[医药卫生—内科学]