糖皮质激素治疗SARS11例胸部影像学变化分析

Change of chest radiograph in severe acute respiratory syndrome(SARS) of 11 death cases treated with glucocorticoid

目的 :探讨 SARS死亡患者糖皮质激素治疗后胸部影像学变化。方法 :回顾性分析 1 1例符合 SARS诊断标准的死亡病例激素治疗前后胸部 X线和 CT图像的影像学变化特点。结果 :应用激素治疗 1周后 ,2例患者肺部阴影有所吸收 ,3～ 4d后病变范围明显增大。3例患者肺部阴影无明显变化 ,3～ 4d后病变范围逐渐增大。 6例患者肺部阴影持续逐渐增大。最终大部分病变融合成大片实变阴影 ,病变范围在 80 %～ 90 % 6例 ,90 %以上 5例。结论 :重症和患有糖尿病、高血压 SARS患者糖皮质激素治疗后胸部影像学变化多样 ,病死率高。胸部影像学对观察疗效和指导治疗有重要作用。

Objective:To study the change of chest radiography of death patients with SARS after treatment with glucocorticoid. Methods:11 death patients of SARS after treatment with glucocorticoid in keep with diagnostic criteria from April to May 2003 were enrolled into the study. The imaging findings of chest X-rays and CT were analyzed in these patients. Results: After 11 death cases of SARS were treated with glucocorticoid for one week , the shadow on lung of two patients was absorbed, but the lesion area expanded obviously after 3～4days. The shadow on lung of three patients didn't change obviously but the lesion area enlarged gradually after 3 to 4 days. The imaging data were progressive deterioration in 6 cases. The mean proportion of lesion area to the whole lung was 80%～90% in 6 cases, 90% above in 5 cases. Conclusion: The radiographic appearances change differently.High mortality rate was found in patients with severe disease, diabetes,hypertension after treatment with glucocorticoid. Recognizing these changes is helpful in estimating curative effect and directing treatment.