严重急性呼吸综合征胸部X线诊断初探  

A Preliminary Study on the Chest X-ray Image of SARS

作　　者：曹智[1] 朱理珉[1] 吉建国[1] 陈利蓉[1] 

机构地区：[1]天津市传染病医院,300192

出　　处：《天津医药》2003年第10期650-652,T001,共4页Tianjin Medical Journal

摘　　要：目的 :探讨严重急性呼吸道综合征 (SARS)患者胸部X线表现特征。方法 :54例SARS患者进行胸部X线检查及分析。结果 :41例 (占75 93 % )患者在发病后2～7d肺部可表现为毛玻璃样阴影 ,且单侧肺出现较多见。33例 (占61 11 % )以右肺中叶及左肺舌叶出现最早 ,继而双肺出现或表现为游走现象。在重症组13例患者中 ,有10例 (占18 52 % )双肺同时出现沿肺纹理走向的局灶性浸润影和 (或 )斑片状浸润影。3例 (占5 55 % )为单肺出现局限病灶后 ,蔓延至双肺。本组预后较差 ,病死率较高。结论 :本病胸部X线表现特点为发病早期肺内即出现异常 ,表现为肺间质病变 ,且较呼吸症状出现早。肺内病变常累及多叶 ,重症者多弥漫双肺 ,很少累及肺尖。未见合并空洞及肺门淋巴结肿大 ,无胸膜渗出性改变。Objective:To study the chest X-ray image of severe acute respiratory syndrome(SARS).Methods:The chest films of54SARS patients were analyzed.Results:Lung infiltrates such as ground-glass shadow were found in41patients(75.93%)from2to7days after onset.The main abnormality was unilateral in the early phase of SARS.The earliest chest radiological appearances occurred in33patients(61.11%)followed by bilateral lung involved.In13patients with severe SARS,local infiltrates and plaque in bilateral lung occurred in10pa-tients.The poor prognosis and the higher mortality were found in severe SARS patients.Conclusion:SARS had characteristic clinical and imaging findings.The lung lesions which showed predominant interstitial lesions were found at the early stage,and were much earlier than syndrome.The lesions were noted in both lungs and mul-ti-lobe and faster progression in sever SARS patients.X-ray sign of pneumonia is the most important for the diagnosis of SARS before the reliable immunology examines.

关 键 词：严重急性呼吸综合征 SARS X线诊断 治疗 流行病学 疗效观察 

分 类 号：R563.1[医药卫生—呼吸系统] R816.41[医药卫生—内科学]