SARS和疑似SARS患者胸部影像学变化的临床研究  

Clinical study on the changes of chest imaging in severe acute respiratory syndrome

作　　者：郑瑞强[1] 邱海波[1] 

机构地区：[1]东南大学附属中大医院危重病医学科,江苏南京210009

出　　处：《东南大学学报（医学版）》2003年第4期217-222,共6页Journal of Southeast University(Medical Science Edition)

基　　金：~~

摘　　要：目的 :总结严重急性呼吸综合征 (SARS)患者胸部影像学动态变化及其与治疗的关系。方法 :分析 7例SARS和疑似SARS患者X线胸片显示肺部病变的出现时间、部位、范围等影像学特点及其与糖皮质激素和白蛋白加速尿治疗的关系。结果 :全部患者发病当时X线胸片就显示有肺部病变。 6例患者累及双肺、多叶。病灶呈进行性发展 ,高峰出现在发病第 8～ 10天。 4例患者应用糖皮质激素〔甲基泼尼松龙 ,1 5～ 3mg·(kg·d) -1〕治疗 ,但不能减轻肺水肿。 5例患者应用白蛋白加速尿治疗后 ,渗出病灶吸收明显。结论 :SARS患者X线胸片渗出病灶出现早、进展快、范围广。糖皮质激素对X线胸片改变无干预作用。白蛋白加速尿可以明显减轻肺水肿。Objective To investigate the relationship between dynamic changes in chest X-ray and therapy to severe acute respiratory syndrome (SARS).Methods The onset time, site, range, and other imaging features of pulmonary lesions in chest radiograph were observed in seven patients with SARS,and their relationship with the therapy of corticosteroid and albumin plus frusemin was studied.Results Abnormal image appeared in chest X-ray in all patients with the onset of the disease.Both lungs were involved and multi-lobe pathological changes were noted in six patients.Chest X-ray radiograms showed progressive changes,which was most severe on the 8 th～10 thday after the onset.Corticosteroid was applied to four patients,but it did not relieve pulmonary edema.The infiltration absorption was obvious with the medication of albumin plus frusemin in five patients.Conclusions For sars patients abnormal image in chest X-ray appears very early and on a large scale,while it progress rapidly.Its shown that corticosteroid has no marked effect to interfere the progression of the disease.Albumin plus frusemin could significantly relieve pulmonary edema.

关 键 词：SARS 严重急性呼吸综合征 疑似SARS 胸部影像学 临床研究 治疗 糖皮质激素 白蛋白 

分 类 号：R563.1[医药卫生—呼吸系统] R816.4[医药卫生—内科学]