105例传染性非典型肺炎X线临床特征

[目的]报道传染性非典型肺炎(SARS)的X线的临床特征。[方法]分析105例SARS的X线胸片表现。所有病人均为本院2003年1月30日至3月31日诊治的患者,均符合我国卫生部的临床诊断标准,有完整的胸部X线照片资料。按病变早期表现及进展情况将其分为两个类型。①渗出型:由肺内局限或多发病灶发展至弥漫分布。②间质型:以肺部间质性炎症为早期主要表现,其后或可出现肺实质渗出性病变。[结果]75例SARS表现为肺内渗出性病灶,25例早期呈间质性炎症,随后出现明显肺内实变。5例主要表现为肺间质性炎症。首次发现肺内病变至病变完全吸收时间,为7～46d,平均19d。[结论]SARS的X线影像学表现以肺实质渗出性病变和间质性炎症为主,首诊后7～10d达高峰。大部分病人肺内病变可完全吸收,目前尚未见有后遗症。

The X-ray Chest Appearances of 105 SARS Cases

[Objective] To report the X-ray appearances of the server acute respiratory syndrome (SARS). [Methods] The plain PA view chest films of 105 SARS patients were analyzed. All of the patients were admitted to our hospital on January 30, 2003 to March 31, 2003. The diagnosis met the criteria of the Ministry of Public Health, P. R. China. According to their 1st chest plain film and the follow-up, the SARS lung changes were divided into two types : (1) exudative lesion: the focal or multiple consolidation evolved to diffuse lesion later. (2) interstitial-exudation: the major appearance on the 1 st X-ray film was interstitial abnormality, and then transformed to the exudation. [ Results ] 75 cases showed exudation and consolidation lesions. 25 cases showed predominant interstitial shadow first, and followed by the lung consolidation. The interstitial lesions were showed in the other 5 cases, without obvious parenchyma exudation. The median duration of SARS was 19 days (range 7-46 days) from the onset of lung abnormality on the 1st X-ray film to resolution. [Conclusion] The predominant abnormalities on the 1st chest film of SARS are parenchyma exudation or/and interstitial lesion. The parenchyma lesions progress fast and reach peak within 7-10 days . The lesions of most patients can be fully resolved. No sequelae are found so far.