SARS患者出院后恢复期的CT表现与肺功能相关性研究

A correlative study of CT findings and pulmonary function test in patients with SARS in the recovery phase following hospital discharge

目的 探讨严重急性呼吸综合征 (SARS)患者恢复期胸部影像学表现及与肺功能的相关性。方法 2 0 0 3年 6～ 8月 ,10 0例SARS恢复期患者接受体检 ,其中 91例在同一天行胸部CT和肺功能检查。男 39例 ,女 5 2例 ;年龄 19～ 6 6岁 ,平均 36 4岁。检查时间距发病时间 5 2～ 12 5d ,平均87 4d。分析患者的肺内CT表现 ,定量分析肺内病变程度和范围 ,分别选择 4个层面 (主动脉弓、隆突、静脉汇合层面和膈上层面 )进行病变评分。并且与肺功能的结果做相关性分析。结果 CT检查示 91例SARS恢复期患者中 4 7例肺内无异常表现 ,4 4例仍然可以见到异常病变 ,包括磨玻璃样病变和网格样阴影。 2种表现的CT评分结果与肺弥散功能 (DLco ,% )存在负相关性 (r =- 0 6 18,P <0 0 0 1;r=- 0 4 98,P <0 0 0 1)。结论 CT显示约半数SARS患者在发病 3个月左右已经完全恢复健康。CT视觉评分可以定量评估肺内残留病变 ,预示肺功能情况。

Objective To evaluate the appearance of CT in patients with severe acute respiratory syndrome (SARS) in the recovery phase, and to study the correlation of CT findings with pulmonary function.Methods From June to August in 2003, 100 patient with confirmed SARS accepted examination in our hospital. Among them, 91 patients (39 men, 52 women, mean age 36.4 years, age range 19- 66 years) received CT examination and pulmonary function test on the same day. The interval between SARS onset and the examination ranged from 52 to 125 days (mean 87.4 days). CT appearances of pulmonary parenchymal abnormalities including distribution and extent of involvement were quantitatively analyzed, and four levels on CT scan including the aortic arch, the tracheal carina, the pulmonary venous confluence, and the dome of right diaphragm were selected to score the lesions. The correlation of CT scores with the results of pulmonary function tests was studied.Results Of the 91 cases, 47 patients had normal CT appearance in the recovery phase, whereas the other 44 patients still had parenchymal abnormalities, including residual ground-glass opacification and reticular shadow. CT visual score had correlation with DLco% ( r =-0.618, P <0.001 vs r =-0.498, P <0.001).Conclusion CT scans show that half of SARS patients has recuperated their health in three months after the initial hospital admission. CT visual score can quantitatively evaluate the abnormal appearance of lungs, and it also indicates the pulmonary function.