SARS流行期间肺炎患者的临床表现和胸部影像变化的探讨

目的 探讨SARS流行期间肺炎患者的临床表现和胸部影像变化特点。方法 对76例SARS流行期间发热留观室收治的肺炎患者的临床表现及胸部影像进行分析。结果 (1)此组肺炎患者多为青壮年(占60．53％)，无固定职业或职业性质流动性较大者居多(69．74％)；(2)临床特征主要是发热，以中高热为多见(80．26％)，发病早期部分患者呼吸道症状并不明显(67．10％)，外周血WBC在正常或低于正常范围(85．53％)，淋巴细胞比例减少(75．00％)；(3)肺部CT表现为不同程度的炎性浸润；病灶形态以斑片状和球形多见(77．63％)；病灶常位于肺周边，常出现支气管气像；动态观察病变影像大多无明显进展(88．16％％)，经治疗均完全吸收。结论 SARS流行期间普通肺炎与非典型肺炎有相似的临床及胸部影像表现；肺部CT扫描能早期发现肺炎患者的异常阴影，明显优于胸片，但无特异性。因此，在SARS流行期间发热诊室医务人员应加强肺部炎性改变的早期诊断和鉴别诊断水平。

Clinical and imaging analysis of patients with pneumonia of SARS

ObjectiveTo understand the clinical and th e thoracic imaging characteristics of pneumonia patients in the epidemics of SAR A.MethodsThe clinical and the chest imaging 76 patients with pneumonia in fever clinics were analyzed.Results(1 )The majority of pneumonia patients were young adults (60.53%)and those who had no fixed profession or heavy flow of profession accounted for 69.74%; (2)Clin ical feature was mainly fever (moderate and high fever accounting for 80.26%) an d the respiratory symptoms of some patients in the early stage o f the outbreaks were not distinct (67.10%),WBC in the peripheral regions was oft en in normal range (85.53%);Lymphocytes ratio lowed (75.00%); (3)Abnormal ches t CT findings were different degree of fibrosis infiltration, the type of the lesions were seen to be patchy and globe, locating in peripheral regions of lung with air bronchium sign. The images of most which were absorbed completely afte r treatment, were observed to have no progress(88.16%).Conclusion The clini cal and the chest imaging appearances between common pneumonia and a typical pne umonia in the epidemics of SARS are similar. Lung CT scanning (better than ches t film, but no specific) can be early found abnormal opacities of pneumonia.