SARS对肺膜弥散量和肺毛细血管血量影响的临床研究

目的研究严重急性呼吸综合征(SARS)的肺弥散能力(DL)、肺泡毛细血管膜弥散能力(Dm)及肺泡毛细血管血容量(Vc)的变化，探讨肺弥散功能障碍的病理生理机制。方法SARS组(26例)及正常对照组12名，测定静息状态下不同氧分压下的DL，按照Roughton和Forster方法计算Dm和Vc。结果SARS组DLco显著低于对照组，A组Dm和、Vc显著低于对照组；肺部病变程度越重，肺弥散功能损害越重，残气容积(RV)低于或高于正常值者也增多。结论SARS患者不仅有Dm而且也有Vc的改变，Dm和Vc的测定对发现SARS肺病变有益，可以明确DL下降的原因及判断病变的程度，是肺弥散功能检查重要和敏感的指标。

Effect of severe acute respiratory syndrome on membrane diffusing capacity and Pulmonary capillary blood volume

Objective To study the changes in pulmonary diffusing capacity (DL), alveolar capillary membrane diffusing capacity (Dm) and pulmonary capillary blood volume (Vc) in patients with severe acute respiratory syndrome (SARS), and to elucidate the underlying pathophysiogical mechanism of reduction of pulmonary diffusing capacity. Method Spirometry was performed in 26 SARS patients and 12 healthy individuals in resting condition. DLco were measured by single breath method, estimations of Dm and Vc were done by the method of Roughton and Forster. Results DLco in SARS patients was significantly lower than that in normal control, the same was true for Dm and Vc. The severer the pulmonary lesion, the heavier the damage to the pulmonary diffusing funetion. Conclusion The changes in Dm and Vc were both found in patients with SARS. Their measurements were helpful for detecting pulmonary involvement in SARS and defining the reason of DL abnormality in SARS. Dm and Vc were important and sensitive for monitoring pulmonary diffusing function in SARS patients