目的:研究重症严重急性呼吸综合征(SARS)临床康复者病后肺功能变化。方法:随访重症SARS患者20例至发病后2年半,检测肺功能及胸CT,分析肺功能与胸部影像学的恢复状况,并对肺功能各项指标与健康体检组及非SARS社区获得性肺炎(CAP)组进行比较分析。结果:随访重症SARS康复者病后1年半20例中,肺功能异常14例,主要是肺弥散功能受损(DLco 56.34±15.96)(占70%);胸部CT表现异常者7例(占33.3%),0级1例;1级6例。患者病后2年半胸CT毛玻璃样改变完全吸收;肺功能(DLco 80.78±9.38)虽低于非SARS社区获得性肺炎组(DLco85.05±13.24),但无显著统计学意义;与健康体检者相比(DLco 102.57±11.74),有显著统计学意义。结论:重症SARS患者康复期存在以弥散功能障碍为主的肺功能损害,及轻度胸部CT异常,随时间的延长均可逐渐恢复,但二者的恢复不是完全平行的,胸部影像学异常的恢复可能早于肺功能。

This paper aimed to investigate the change of pulmonary function for severe acute respiratory syndrome(SARS) convalescent patients.Twenty severe SARS convalescent patients who had been released from hospital for two-and-a-half years were followed up.The follow-up research included pulmonary function test and chest CT at one-and-a-half years and two-and-a-half years for the study of pulmonary function recovery and chest radiology.The comparison was made on pulmonary function test and chest CT among severe SARS patients,healthy control group and the community-acquired pneumonia(CAP) group.The results showed that in the follow-up of one-and-a-half years,the abnormal changes of pulmonary function were found in 14 out of 20 patients.The main disorder was impaired pulmonary diffusion capacity for carbon monoxide(DLco 56.34 ±15.96).Seven of 20 severe SARS convalescent patients were found abnormal changes in the chest CT.The comparison between the follow-up of two-and-a-half years among 20 severe SARS convalescent patients and the CAP group showed no significant difference.Comparing to the healthy control group,significant difference of DLco was detected.It is concluded that in convalescent stage,the impaired pulmonary function of severe SARS convalescent patients may recover gradually,but the improvement of DLco was comparatively slow.The recovery of chest radiology may be earlier than the recovery of impaired pulmonary function.

煤炭总医院科研课题(04-4):SARS临床康复者医学追踪观察研究,负责人:何晓蕴。