SARS治愈病例与死亡病例胸部X线表现比较

目的 探讨SARS死亡病例胸部x线表现。方法 回顾性分析11例SARS死亡病例的胸部x线表现，并与249例治愈病例做对比分析。结果 11例SARS死亡病例的胸部主要x线表现为：斑片状影10例(90．90％)，大片状影8例(72．73％)，大范围肺实变8例(72．73％)，间质改变10例(90．90％)，磨玻璃样改变9例(81．82％)，弥漫性病变11例(100％)，双肺受累9例(81．82％)。对比分析显示大片状影、大范围肺实变、磨玻璃样改变、弥漫性病变这4种x线表现在死亡病例与治愈病例的差异具有统计学意义(P＜0．01)。结论 大片状影、大范围肺实变、磨玻璃样改变、弥漫性病变、双肺受累，尤其是大范围肺实变和弥漫性病变是SARS死亡病例的主要x线表现。绝大多数SARS死亡病例死亡前最后一次胸片显示双侧肺野广泛的内有支气管气像的磨玻璃样改变。

SARS: a comparative study on the chest radiography of the mortal cases and the cured cases

Objective This study is mainly on the radiological findings of the mortal cases of SARS. Methods The chest X-ray (CXR) findings of 11 mortal cases of SARS were retrospectively studied, and compared with those of the 249 cured cases. Results The major CXR findings of the mortal cases were: patchy shadows in 10 cases out of 11 (90.90%), large shadows in 8 (72.73%), extensive consolidation in 8 (72.73%), interstitial lesions in 10 (90.90%), frosted glass like change of the lung fields in 9 (81.82%), diffuse lesions in 11 (100%), and involvement of the bilateral lung. There was a statistical difference between the mortal cases and the cured cases on the following 4 manifestations: large shadows, extensive consolidation, frosted glass like change of the lung fields, and diffuse lesions (P< 0.01). Conclusion Large shadows, extensive consolidation, frosted glass like change of the lung fields, diffuse lesions and the bilateral involvement of the lung are the main CXR findings of the mortal cases of SARS. And extensive consolidation and diffuse involvement are strongly indicative. In most of the mortal cases, the latest CXR demonstrated widespread frosted glass like appearance in the lung fields with air bronchogram.