Long-term bone and lung consequences associated with hospital-acquired severe acute respiratory syndrome:a 15-year follow-up from a prospective cohort study  

作　　者：Peixun Zhang Jia Li Huixin Liu Na Han Jiabao Ju Yuhui Kou Lei Chen Mengxi Jiang Feng Pan Yali Zheng Zhancheng Gao Baoguo Jiang 

机构地区：[1]Department of Orthopedics and Trauma,Peking University People’s Hospital,Beijing,China [2]Department of Respiratory Medicine,Peking University People’s Hospital,Beijing,China [3]Department of Clinical Epidemiology and Biostatistics,Peking University People’s Hospital,Beijing,China [4]Department of Central Laboratory,Peking University People’s Hospital,Beijing,China [5]Department of Education,Peking University People’s Hospital,Beijing,China [6]Department of Radiology,Peking University People’s Hospital,Beijing,China

出　　处：《Bone Research》2020年第1期107-114,共8页骨研究（英文版）

基　　金：supported by Innovation Team of the Ministry of Education (IRT1601);the National Key Research and Development Programme of China (2016YFC0903800);the National Natural Science Foundation (31771322, 31571235);Fostering Young Scholars of Peking University Health Science Center (BMU2017PY013);Beijing Science & Technology New Star Cross Project (201819)

摘　　要：The most severe sequelae after rehabilitation from SARS are femoral head necrosis and pulmonary fibrosis. We performed a 15-year follow-up on the lung and bone conditions of SARS patients. We evaluated the recovery from lung damage and femoral head necrosis in an observational cohort study of SARS patients using pulmonary CT scans, hip joint MRI examinations, pulmonary function tests and hip joint function questionnaires. Eighty medical staff contracted SARS in 2003. Two patients died of SARS, and78 were enrolled in this study from August 2003 to March 2018. Seventy-one patients completed the 15-year follow-up. The percentage of pulmonary lesions on CT scans diminished from 2003(9.40 ± 7.83)% to 2004(3.20 ± 4.78)%(P < 0.001) and remained stable thereafter until 2018(4.60 ± 6.37)%. Between 2006 and 2018, the proportion of patients with interstitial changes who had improved pulmonary function was lower than that of patients without lesions, as demonstrated by the one-second ratio(FEV1/FVC%, t = 2.21, P = 0.04) and mid-flow of maximum expiration(FEF25%–75%, t = 2.76, P = 0.01). The volume of femoral head necrosis decreased significantly from 2003(38.83 ± 21.01)% to 2005(30.38 ± 20.23)%(P = 0.000 2), then declined slowly from 2005 to 2013(28.99 ± 20.59)% and plateaued until 2018(25.52 ± 15.51)%. Pulmonary interstitial damage and functional decline caused by SARS mostly recovered, with a greater extent of recovery within 2 years after rehabilitation. Femoral head necrosis induced by large doses of steroid pulse therapy in SARS patients was not progressive and was partially reversible.The most severe sequelae after rehabilitation from SARS are femoral head necrosis and pulmonary fibrosis. We performed a 15-year follow-up on the lung and bone conditions of SARS patients. We evaluated the recovery from lung damage and femoral head necrosis in an observational cohort study of SARS patients using pulmonary CT scans, hip joint MRI examinations, pulmonary function tests and hip joint function questionnaires. Eighty medical staff contracted SARS in 2003. Two patients died of SARS, and78 were enrolled in this study from August 2003 to March 2018. Seventy-one patients completed the 15-year follow-up. The percentage of pulmonary lesions on CT scans diminished from 2003（9.40 ± 7.83）% to 2004（3.20 ± 4.78）%（P < 0.001） and remained stable thereafter until 2018（4.60 ± 6.37）%. Between 2006 and 2018, the proportion of patients with interstitial changes who had improved pulmonary function was lower than that of patients without lesions, as demonstrated by the one-second ratio（FEV1/FVC%, t = 2.21, P = 0.04） and mid-flow of maximum expiration(FEF25%–75%, t = 2.76, P = 0.01). The volume of femoral head necrosis decreased significantly from 2003（38.83 ± 21.01）% to 2005（30.38 ± 20.23）%（P = 0.000 2）, then declined slowly from 2005 to 2013（28.99 ± 20.59）% and plateaued until 2018（25.52 ± 15.51）%. Pulmonary interstitial damage and functional decline caused by SARS mostly recovered, with a greater extent of recovery within 2 years after rehabilitation. Femoral head necrosis induced by large doses of steroid pulse therapy in SARS patients was not progressive and was partially reversible.

关 键 词：doses consequences slowly 

分 类 号：R511.9[医药卫生—内科学] R681[医药卫生—临床医学]