普通型及重型COVID-19患者139例胸部CT出院后随访  

The post-discharge follow-up on chest CT study of 139 patients with moderate and severe COVID-19

作　　者：林琳[1] 骆伟杰 张烈光[1] 杨彦鸿 张志平 余成成 黄德扬[1] 江松峰 陈碧华 刘晋新[1] LIN Lin;LUO Wei-jie;ZHANG Lie-guang;YANG Yan-hong;ZHANG Zhi-ping;YU Cheng-cheng;HUANG De-yang;JIANG Song-feng;CHEN Bi-hua;LIU Jin-xin(Department of Radiology,Guangzhou Eighth People's Hospital MGuangzhou Medical University,Guangzhou 510060,Guangdong,China)

机构地区：[1]广州医科大学附属市八医院放射科,广东广州510060 [2]广州市花都区人民医院放射科,广东广州510800

出　　处：《广东医学》2021年第10期1156-1160,共5页Guangdong Medical Journal

摘　　要：目的通过分析普通型及重型新型冠状病毒肺炎(COVID-19)患者出院后半年内的胸部CT表现,探讨其肺内残余病灶的转归情况。方法收集出院后半年内进行随访的139例COVID-19患者的一般资料(年龄、发病至病灶完全吸收时间等)及影像学资料(肺内病灶累及的范围、分布、CT表现等)。根据疾病严重程度,将其分成普通型组(n=121)及重型组(n=18),采用半定量评分系统评估肺受损程度,并利用SPSS22.0统计软件对所收集的数据进行分析、比较。结果重型组患者平均年龄高于普通型组患者;重型组患者双肺病灶累及范围较普通型组患者广泛,且吸收速度较慢,出院后半年内,仅3例(17%)患者肺部病灶完全吸收,而在普通型组患者中该比例高达76%,普通型组患者发病至肺内病灶完全吸收平均(124±58)d,重型组为(159±45)d。肺内残余病灶最常见的影像学表现为磨玻璃密度影及条索影,而实变影、蜂窝影、支气管扩张、胸腔积液及淋巴结肿大未见显示。结论大部分普通型及重型COVID-19患者的肺内残余病灶是可逆的。重型肺炎患者肺内病灶吸收缓慢,随访时间需长达1~2年,而大部分普通型肺炎患者肺内病灶吸收较快,随访时间仅需半年。Objective To analyze the chest-CT features of patients with moderate and severe coronavirus disease 2019(COVID-19)within 6 months after discharge and to access the prognosis of the residue pulmonary lesions.Methods The general data(age,time of onset to complete absorption of lesions,and etc.)and imaging data of 139 COVID-19 patients,who were diagnosed and discharged and were followed up within half a year after discharge,were collected.According to the severity of disease,the patients were divided into the moderate group(n=121)and the severe group(n=18).A Semi quantitative scoring system was used to evaluate the extent of lung involvement,and SPSS 22.0 statistical software was used to analyze and compare the collected data.ResultsThe patients in the severe group were elder,with severer extent of lung involvement and slower absorption rate than those in the moderate group.Only 3 patients(17%)had completely resolved within 6 months after discharge,while that percentage in the moderate group reached 76%.The average time of onset to complete absorption was(124±58)days in the moderate group and(159±45)days in the severe group.The most common features of residue lesions were ground-glass opacity and linear opacity,and no abnormalities of consolidation,honeycomb shadow,bronchiectasis,pleural effusion or lymph node enlargement were found on chest CT.ConclusionsThe residual lung lesions are reversible in most COVID-19 patients.Patients with severe pneumonia have a slow clearance of lung lesions,and the required follow-up time should be 1-2 years;while most patients with moderate pneumonia have a faster clearance of lung lesions,and the required follow-up time is only half an year.

关 键 词：新型冠状病毒肺炎 胸部CT 随访研究 

分 类 号：R445.3[医药卫生—影像医学与核医学] R512.99[医药卫生—诊断学]