严重急性呼吸综合征患者特异性抗体X线胸片和肺功能的变化  

The changes of SARS-IgG,X-ray of lung and lung function in patients with severe acute respiratory syndrome .

作　　者：吴华[1] 郑则广[1] 陈荣昌 黎毅敏[1] 郑劲平[1] 曾庆思[1] 莫红樱[1] 任筱兰[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,广东广州510120

出　　处：《中国实用内科杂志：临床前沿版》2006年第2期264-266,共3页

基　　金：基金资助:国家863计划(No.2003AA208107);广东省卫生厅课题(No.A2004274);广州市科技计划项目(No.2004J1-C0212)

摘　　要：目的通过对严重急性呼吸综合征（SARS）患者出院后血清特异性抗体免疫球蛋白G（IgG）、X线胸片和肺功能的跟踪观察，了解其变化的规律。方法对2003-06～2004-04广州医学院第一附属医院广州呼吸病研究所103例SARS患者出院后定期检查血清特异性抗体IgG、胸片和肺功能，并将其IgG血清浓度与20例健康的医务人员对照比较。结果（1）SARS患者发病第3天起血清IgG的吸光度（OD）值为（0．063±0．012），与正常对照组（0．016±0，019）比较差异存在显著性（P=0．000），此后逐渐增高，于发病后第3周明显增高达（0．180±0．202），于第4个月达最高值（1．730±0．331），此后逐渐下降，发病后第17个月为（0．668±0．109）；（2）62例SARS患者发病后前3个月X线胸片恢复正常的比例为32．3％，发病后第17个月恢复正常的比例为56．5％，异常者有5例，均为重症患者，剔除中断复查的患者（22例），则第17个月胸片正常率为80％；（3）25例SARS患者发病后6个月内肺功能正常者16例，异常者9例，其中4例异常者3～6个月后复查均有不同程度恢复。结论SARS患者发病后第3天血清IgG的OD值可作为诊断的筛选实验，发病第3周明显增高时可确诊；SARS患者的肺部间质性病变和肺功能损害均可逐渐恢复。Objective To investigate the changes of SARS - IgG in serum, X - ray of lung and lung function in severe acute respiratory syndrome （SARS） patients. Methods During the period of 2003 - 06 - 2004 - 04, the SARS - IgG in serum, X -ray of lung and lung function tests were checked up in 103 SARS patients by Guangzhou Institute of Respiratory Disease in regularly every 3 months after their discharge from hospital and the SARS - IgG level in serum was compared with another 20 healthy medical workers. Results 1. On the third day after the onset of SARS disease, the optical density （OD） value of SARS - IgG in serum was （0. 063 ±0. 012） which was significantly higher than the normal control group. Moreover, from then on, it increased step by step and went up greatly in the third week （0. 180 ± 0. 202） and attained the highest level （ 1. 730 ±0. 331 ） in the fourth month. Then it decreased step by step and in the 17th month, it dropped to （0. 668 ±0. 109） . 2. The chest X - ray of 32. 3%of 62 cases became normal in the first 3 months after onset of SARS and that of 56.5% did in the 17th month. However, if 22 cases were taken into account, who did not have a re - check, 80% of the cases became normal and the left 5 cases were severe patients. 3. The lung function of 16 of 25 cases became normal in 6 months after onset and among the other 9 cases, the lung function of 4 cases had an improvement in the following 3 to 6 months. Conclusion The OD value of SARS - IgG in serum in the third day can be used as a screening test of SARS. Its remarkable increase in the third week will support the diagnosis. The chest X - ray and lung function of SARS patients will improve gradually and become normal in the final.

关 键 词：严重急性呼吸综合征 IGG 肺功能 X线胸片 

分 类 号：R5[医药卫生—内科学]