天津地区严重急性呼吸综合征患者康复10年后肺功能状态

The lung function status in patients with severe acute respiratory syndrome after ten years of convalescence in Tianjin

目的 评估严重急性呼吸综合征（SARS）患者康复10年后的肺功能恢复状况及SARS对患者肺功能的影响.方法 对本院2003年确诊为SARS的25例康复患者进行肺功能检测,分别测定肺总量、残气量、肺活量、用力肺活量（FVC）、FEV1、FEV1/FVC和肺一氧化碳弥散量（DLCO）,并与2003年初始恢复期的肺功能指标进行自身对比.25例中男3例,女22例,年龄31 ～ 69岁,平均（45.8±12.2）岁.选取同期25名健康成人体检者,男6名,女19名,年龄31 ～ 62岁,平均（42.3±11.9）岁,对二者的肺功能指标进行对比分析.结果 25例中单纯弥散障碍2例,单纯限制性通气功能障碍2例,弥散障碍合并限制性通气功能障碍11例,弥散障碍合并阻塞性通气功能障碍1例.肺功能无异常患者10例.10年后和10年前主要的肺功能指标DLCO为（73±12）％和（72±15）％,FEV1/FVC为（83±11）％和（85±7）％,FEV1为（88±7）％和（86±14）％,FVC为（87±21）％和（87±17）％、残气量为（100±17）％和（78±30）％,各项指标比较差异均无统计学意义（均P＞0.05）,同时与健康体检者比较差异均无统计学意义（均P＞0.05）.结论 SARS患者康复10年后肺通气功能基本恢复正常,肺功能损害以弥散及限制性通气功能障碍为特征.

Objective To evaluate the lung function in patients with severe acute respiratory syndrome （SARS） 10 years after recovery and the influencing factors.Methods Pulmonary function tests were performed in 25 convalescent patients who had a diagnosis of SARS in 2003.Total lung volume,residual capacity,vital capacity,forced vital capacity （FVC）,FEV1,FEV1/FVC and lung carbon monoxide diffusion （DLCO） were measured,and compared with the values obtained immediately after recovery in 2003.Of the 25 cases,3 were males and 22 were females,aging 31-69 years [average （45.8 ± 12.2）].Twenty-five healthy adults （6 males,19 females）,aged 31-62 years [average （42.3 ± 11.9） years],were recruited as controls.Results Of the 25 cases,2 showed simple diffusion dysfunction,2 simple restrictive ventilatory dysfunction,11 combined diffusion and restrictive ventilatory dysfunction,and 1 combined diffusion and obstructive ventilatory dysfunction.The remaining 10 cases showed normal lung function.There were no statistical differences in the pulmonary function measurements as compared with those measured 10 years ago,including DLCO（73 ± 12）％ vs（72 ± 15）％ （P ＞0.05）,FEV1/FVC （83 ± 11）％ vs （85±7）％,（P＞0.05）,FEV1（88 ±7）％ vs（86±14）％ （P＞0.05）,FVC（87 ±21）％ vs （87±17）％ （P＞0.05）,and RV（100±17）％ vs （78 ±30）％ （P＞0.05）.Thelungfunctions of the patients showed no significant difference as compared with those obtained from the healthy controls.Conclusions The pulmonary functions of SARS patents largely returned to normal after 10 years of convalescence,and the lung function damage was characterized by diffusing and restrictive ventilatory dysfunctions.