严重急性呼吸综合征(SARS)45例胸部影像学动态变化分析

Analysis the dynamic variation of ch est X -ray image in 45 SARS patients

目的对SARS患者胸部影像学的动态变化进行分析。方法对2003年3月至5月间有完整胸部影像学动态变化的45位SARS患者进行分析。结果普通型23例:肺部出现一侧片状阴影为病程的2～5天,平均2.9±1天,中位数为3天;发展到双侧为2～11天,平均6.9±2.5天,中位数为7天;出现双肺广泛磨玻璃样变、实变为6～19天,平均11±2天,中位数11天;开始吸收为10～21天,平均15±4.1天,中位数15天;胸部影像学完全吸收为18～46天,平均25.9±7.2天,中位数为24天。重型患者22例:发展到双肺广泛磨玻璃样变、实变为9±3.2天,与普通型相比,差异无显著性(P>0.05),开始吸收为19±4.6天(P=0.009),胸部影像学完全吸收为36±8.1天(P=0.001),其中7例死亡患者胸部影像学均在7天内进展到双肺广泛实变。结论SARS患者胸部影像学变化迅速、进展快,从单侧病变发展到双侧病变约在7天左右,发展到双肺广泛磨玻璃样变、实变大约在11天左右。1周之内进展到双肺广泛实变的患者,可能预后极差。

Objective To analyze the dynamic variation of c hest X -ray image in 45SARS patients.Methods 45SARS patients with the series of dynamic variation of chest X -ray image fr om March to May 2003was analyzed.Results For all45cases,Common type in 23:the time f or appearance of patched shadow in la teral of lung was 2to 5days,the avera ge time was2.9±1days,median time was 3days.The time to patched shadow of bilateral of lung appearance was 2to 12days,the average time was 6.9±2.5days,median time wa s 7days.To ground glass or consolidation appearance in lung was 6to 19day s,the average time was 11±2days,median time was 11days.The time for chest X -ra y image began to absorb was 10to 21day s,the average time was 15±4.1days,median time was 15days.The time for chest X -ray image absorption completely was18to 46days ,the average time was 25.9±7.2d ays ,median time was 24days.For 22se vere type patients,in which the time to ground glass of lung appearance was 9±3.2days,it had no significance difference compared with common type(P<0.05),the time for begin to absorb was 19±4.6(P=0.009)days and 36±8.1days(P=0.001)for complete absorption.Particula rly,the time to pan -consolidation appearance in lu ng less than 7days for seven death patients.Conclusion SARS patients were usually with rapid variation and progression of c hest image.The time patched shadow o f bilateral of lung appearance was 7d ays and 11days for the time to ground glass or consolidation appearance in lung .The time for X -ray went to pan -consolidation app earance less than seven days will associated with bad p rognosis.[