SARS的胸部X线表现

The chest X-ray appearances of SARS

目的 报道严重急性呼吸综合征 (SARS)的胸部X线表现。方法 分析 10 5例SARS的胸部X线表现及特征。所有病人均为 2 0 0 3年 1月 30日至 3月 31日期间诊治的病人 ,并符合中华人民共和国卫生部制定的《传染性非典型肺炎临床诊断标准 (试行 )》 ,在住院治疗期间有完整的胸部X线片资料。根据病变早期表现及进展情况 ,将其分为 4型。 (1)局限型 :由肺内单一局部病灶到病变发展或广泛分布。 (2 )多发型 :早期即见肺内多发片状或 (和 )结节状病灶。 (3)间质 实质型 :以肺部间质性炎症为早期主要表现 ,其后出现明显的肺实质渗出性病变。 (4)间质型 :以肺间质异常为主要表现。结果 SARS患者的胸部X线表现形式多样 ,75例表现为肺内渗出性实变病灶 ,其中局限型 5 7例 ,多发型 18例。 2 5例呈间质性炎症征象 ,随后出现明显肺内实变。 5例主要表现为肺间质性炎症。首次见肺内病变至病变完全吸收的时间为 7～ 4 6d ,平均为 19d。结论 SARS的X线表现以肺实质渗出性病变和间质性炎症为主 ,病变早期发展迅速 ,肺内实变于首诊后 7～ 10d达高峰 ,其后大部分病人可完全吸收。绝大多数病人预后良好 ,目前尚未见有后遗症。

Objective To report the chest X-ray appearances of the severe acute respiratory syndrome(SARS). Methods The chest films of 105 SARS patients were analyzed. All the patients were admitted by our hospital from January 30 to March 31, 2003, and the diagnoses met the diagnostic criterion of IAP made by the Ministry of Public Health, P.R.China. According to their first X-ray film appearances and progression, the patterns of lung lesions were categorized to four types: (1)focal lesion: the single and focal consolidation developed to diffuse lesion. (2)multiple lesions: the first X-ray film showed multiple patchy lesions or/and noodles. (3)interstitial-parenchyma: the major appearance on the first X-ray film was interstitial abnormality, followed by the major parenchymal lesion. (4)interstitial lesion: interstitial abnormality was predominant. Results The chest radiological appearances of SARS were multiform. 75 cases (57 cases of focal lesion and 18 cases of multiple lesions) showed exudation and consolidation lesions, and 25 cases showed predominant interstitial lesion, followed by the lung consolidation. The interstitial lesions were showed in the other 5 cases, without obvious parenchymal exudation. There was a median interval of 19 days (range 7-46 days) from the onset of abnormality on the first X-ray film to the resolution. Conclusion The predominant abnormalities of SARS on the first X-ray film were parenchymal exudation or/and interstitial lesion. The lesions progressed quickly at the early stage and reached at a peak within 7-10 days. The lesions in most patients would be fully resolved. Most patients have good prognosis, and sequela haven′t been found yet so far.