传染性非典型肺炎X线影像演变分析

目的]分析传染性非典型肺炎(severe acite resoratpru sumdrp,e.SARS)的肺部X线影像特征和演变规律。方法]将2003年2月-2003年4月在广州中医药大学第二附属医院收治的85例SARS患者胸部X线检查资料进行回顾性总结，分别统计在疾病的早期、进展期、高峰期和吸收期内肺部X线影保病灶的出现、分布、形态及进展状况。结果]72．9％的患者在发热3-4d期间出现肺部X线阴影，个别(1例)阴影在发热第8天才出现；病灶的分布在疾病的不同阶段有不同的特点，早期位于下肺所占比例(88．2％)明显多于其他肺叶，进展期和高峰期病灶大多数累及两个以上肺叶，所占比例分别为58．8％和80％，并且病变发展迅速，一旦肺内出现阴影，病灶迅速扩散至一例或双侧大片肺野，病灶呈多叶的患者占了全部病例的80％；病灶形态早期以斑片状分布为主，部分呈网格样，进展期病灶大多数为云雾状和毛玻璃样变，高峰期以毛玻璃样变为主，吸收期以云雾状；斑片为主，少部分残留有纤维条索阴影。结论]非典型肺炎胸部X线影像的形态和演变过程有其自身的特点和规律性，与临床结合起来，可有助于对SARS的诊断及其预后的判断。

Changes of Chest X-Rays in Severe Acute Respiratory Syndrome

Objective] To study the features and changes of chest X-rays in severe acute respiratory syndrome (SARS) . Methods] A retrospective study on the results of chest X-rays was carried out in 85 SARS patients admitted to the second affiliated hospital of Guangzhou University of TCM from February to April of 2002. The occurrence, distribution and shape of the focus., as well as its progress, were investigated in the stages of occurrence, development, fastigium and absorption. Results] Chest X-ray showed that shadows were found on the 3rd or 4th day of febrile course in most cases (72.9%) and on the 8th day in only one case. Distribution of focus varied in different stages. In the early stage, Lesions focused on the lower lobe in 88.2% of the cases, which was much more than that in other lobes. Lesions involved more than two lobes in 58.8 % of the cases in the developing stage and 80% in the stage of fastigium. Once the shadow occurred, the lesions quickly diffuse to unilateral or bilateral lung, with 80% of the cases having the multifocal leion. Shadows were patchy in most of the cases and reticular in some in the early stage, cloudy and ground-glass-like in most of cases in the developing stage, ground-glass-like in the stage of fastigium and in the stage of absorption cloudy and patchy in most of the cases and streak-like in a few cases. Conclusion ] The typical features and changes of chest radiographs in SARS are the valuable information for the diagnosis and the prognosis of SARS.