北京地区患严重急性呼吸综合征医务人员的胸部高分辨率CT与肺功能随访分析

A follow-up study of the lung function and the chest CT changes in medical staff with severe acute respiratory syndrome in Beijing

目的 分析医务人员患严重急性呼吸综合征 (SARS)后肺部恢复情况。方法 对北京地区 2 0 0 3年在医疗工作岗位上感染SARS病毒发病的 4 5 6例医务人员 ,于 2 0 0 3年 12月至 2 0 0 4年 2月进行胸部高分辨率CT(HRCT)和肺功能测定。结果 在 4 0 6例进行肺通气功能检测的患者中 ,31例 (7 6 4 % )异常 ;4 0 4例进行肺弥散功能检测 ,其中 16 5例 (40 84 % )异常 ;4 34例进行胸部HRCT检查 ,15 1例 (34 79% )异常 ,表现为磨玻璃密度阴影、网格状阴影和胸膜下弧线影等 ;395例同时接受肺弥散功能检测和胸部HRCT检查 ,5 5例 (13 92 % )两项均异常 ,且HRCT显示双肺病变典型者的肺弥散功能较HRCT正常者有显著的下降 ,两组差异有统计学意义。结论 SARS病毒感染的医务人员在康复出院后尚有部分患者遗留肺功能降低、胸部HRCT异常等问题 ,提示肺部损伤为慢性改变 ,应对此类患者继续随访。

Objective To analyze the lung function and radiological changes in rehabilitating severe acute respiratory syndrome(SARS) patients of medical staff in Beijing. Methods Follow-up lung function tests and chest high-resolution computerized tomography(HRCT)were performed in medical staff with SARS from Dec. 2003 to Feb. 2004. Results Thirty-one(7.64%) of 406 patients showed abnormal ventilatory function, while 165 of 404 patients showed diffusing abnormality. Of the 434 patients who had received HRCT scans,151(34.79%) showed abnormalities including subpleural and basal ground-glass and reticular attenuation,nodular septal thickening and bronchiectasis. Of the 395 patients who had received both lung function test and HRCT scanning,55(13.92%) had abnormalities both in the lung function and HRCT. The decrease in diffusing capacity in patients with HRCT changes was more significant than those without HRCT changes. Conclusions Lung function and lung imaging were abnormal in some patients with SARS after recovery. It is suggested that the lung damage is chronic,and follow-up is needed.