重症急性呼吸道综合征的临床表现和影像动态变化  

Clinical Manifestations and Eynamic Imaging Changes in Severe Acute Respiratory Syndrome Diagnosed Clinically

作　　者：赵启利[1] 王海枝[1] 李乐天[1] 凌惠珠[1] 

机构地区：[1]河北省廊坊市医院,065000

出　　处：《张家口医学院学报》2004年第1期6-8,共3页

摘　　要：目的 :探讨重症急性呼吸道综合征 (SARS)的影像及临床表现和特征。方法 :回顾性分析 17例经临床证实及 /或实验室检测证实的SARS的影像动态变化和临床表现。结果 :影像表现 :多在发热 3d内出现肺部阴影 (10例 ) ,以片状为主 (16例 ) ,可为单侧 (9例 ) ,也可为双侧 (8例 ) ,两肺中下野多发 ,常为多叶段同时发病。病变多在发病 1～ 7d明显进展加重 ,此起彼伏 ;多在两周内开始吸收。临床均以发热为首发症状 (17例 ) ,体温 >38.℃ ,以咳嗽 (15例 )、咳痰 (12例 )、乏力 (10例 )和肺部音 (11例 )为主要症状体征。白细胞正常或降低 ,淋巴细胞减少或偏低。抗生素治疗不敏感。结论 :影像学检查是诊断该病和观察病情变化的最重要指标之一。Objective: To research imaging and clinical manifestations and characteristics of the severe acute respiratory syndrome(SARS). Methods:Dynamic imaging changes and clinical manifestations of the SARS proved by clinical characteristics and/or examined in laboratory were studied retrospectively. Results: Imaging manifestations: The most spots of lung appeared in 3 days after fever occurred(10 cases).The most appearance of the spots. was patchy(16 cases).They could appear on one side (9 cases) or two sides(8 cases) of lung.The most shadow was found in the middle and lower part on the cobe of the lung. The spot often come on in many lobar bronchas or segmental bronchas.These syndrom progressed rapidly within 1～7 days and rose one after another.The first absorption of the abnormal changes on the chest films ussally presented within 2 weeks in most cases.The first clinical symptom was fever in all cases(17 cases),T>38℃.The major symptom was cough (15 cases),expectoration(12 cases),tiredness(10 cases)and rale in lung(11 cases).White blood cell was normal or reduced. Lymphocyte is reduced or low.The curative effect wasn't obvious by antibiotic. Conclusion:Medical imaging is one of the most important indexes for diagnosing and observing the changes. We can give a definite diagnosis by combining imaging with clinical finding and laboratory test, especially epidemiology.

关 键 词：重症急性呼吸道综合征 SARS 影像学 流行病学 冠状病毒 

分 类 号：R563.8[医药卫生—呼吸系统] R445[医药卫生—内科学]