SARS康复者肺部CT表现及肺功能恢复与临床的联系

目的：探讨严重急性呼吸综合征（SARS）康复者的肺部CT表现及肺功能恢复情况与临床的联系。方法：49例SARS康复者出院后30～122天进行肺部螺旋CT和/或高分辨CT复查，同期40例进行了肺功能复查，分别有16例和13例康复者出院后120～245天再次进行CT复查和肺功能复查。对康复者的临床资料进行回顾性分析，用CT视觉评分方法定量分析肺内病变。结果：首次49例复查的肺部CT表现为磨玻璃阴影25例（51.0％），间质阴影22例（44.9％），随后16例复查的情况分别为6例（37.5％）和7例（43.8％）。CT视觉评分比较两次CT复查的征象，磨玻璃影有明显吸收，但间质阴影吸收缓慢。住院期间合并成人呼吸窘迫综合征（ARDS）者其磨玻璃阴影评分明显比没有合并ARDS者高。肺弥散功能占预计值的百分比（Dlco％）的恢复与性别和肺部磨玻璃阴影评分有关。结论：SARS康复者肺部CT表现与临床、实验室检查和肺功能密切相关，随时间的延长，肺内病灶及肺功能逐渐好转，但间质阴影吸收缓慢。

The correlation between high resolution CT findings and recovery of respiratory function tests in SARS patients in the convalescent phase

Objective: To study the correlation between high resolution CT(HRCT) findings, recovery of respiratory function tests and clinical data of SARS patients in the convalescent phase. Methods: Forty-nine patients with confirmed SARS underwent initial thin-section CT and forty patients underwent respiratory function tests. Sixteen and thirteen patients underwent follow-up examination. The clinical data were retrospectively analysed. CT visual score were quantitatively analyzed for lung abnormalities. Results: Ground-glass opacities and interstitial opacities were found in 25(51%), 22(45%) of the 49 patients on initial HRCT and in 6(38%), 7(44%) of the 16 patients on the follow-up HRCT examinations. The initial and follow-up CT visual score indicated a significant reduction in the extent of ground-glass opacity(P<0.001) but not in that of interstitial opacity. Scan from patients with adult respiratory distress syndrome(ARDS) had a significantly higher score for ground-glass opacity than did those from patients without ARDS(P<0.05). Dlco% were correlated with sex and ground-glass opacity score. Conclusion: HRCT findings were correlated with clinical data, laboratory tests and respiratory function tests, residual abnormalities and respiratory function tend to be better over the time, but interstitial opacity persists.