嚴重急性呼吸綜合征患者肺部殘留

病變CT 遠期隨訪研究
劉長柱 程國英 馮元博 劉月 華琳 彭堃
【摘要】 目的 探討嚴重急性呼吸綜合征( SARS) 患者肺部殘留病變CT 遠期動態變化特點及
相關殘留因素分析。方法 隨訪50 例SARS 患者( 男16 例, 女34 例) , 分別于發病后3、6、9、14、24 個
月行螺旋CT 常規掃描和高分辨率掃描。結果 ( 1) 3 個月隨訪顯示24 例肺內殘留病變基本吸收,
6 個月吸收30 例, 14 個月35 例, 24 個月37 例, 仍有13 例肺內殘留病變, 其中磨玻璃樣病灶8 例, 細
網狀影4 例, 索條影6 例, 胸膜下弧形影2 例, 合并牽拉性支氣管擴張2 例。( 2) 回顧性對比3 個月肺
內病灶殘留組與吸收組患者發病不同時期( 3 ～21 d) 胸部影像特點, 顯示在病灶大小及進展方面差異
有統計學意義( P < 0. 05) 。( 3) 比較2 個年齡組( ≥40 歲24 例, < 40 歲26 例) 隨訪不同階段肺內病
灶殘留率, 差異均有統計學意義( P 值均< 0. 05) 。結論 26% ( 13 / 50) SARS 患者于24 個月隨訪仍
可見肺內病變殘留, 病灶仍以磨玻璃樣病灶為主( 8 /13) , 并伴有肺間質增生及纖維化; 年齡≥40 歲的
患者, 肺內易殘留病變。
【關鍵詞】 嚴重急性呼吸綜合征; 體層攝影術, X 線計算機; 隨訪研究
Long-term follow-up study for the r emaining lesions of lungs in patients with SARS LIU Changzhu,
CHENG Guo-ying, FENG Yuan-bo, LIU Yue, HUALin, PENG Kun. Depa rtment of Radiology, Beijing
Sixth Hospita l, Beijing 100007, China
【Abstra ct 】 Objective To study the dynamic CT features of severe acute respiratory syndrome
( SARS) in recovery phase, and to analyze the correlative remaining factors on CT images. Methods Total
50 patients with SARS were followed-up with chest spiral CT and HRCT in 3, 6, 9, 14, 24 months after
onset. Results ( 1) The pulmonary lesions were completely absorbed in 24 cases in 3 months, 30 cases in
6 months and 37 cases in 24 months. Abnormal CT findings were showed in 13 patients later, which
appeared ground-glass opacity 8, irregular lines 6, thickening of interlobular septa 4, subpleural lines 2 and
bronchiectasis 2. ( 2) Reviewing the lesions on CT between the remained group in the third month and the
absorption group, there was a difference in the extent and the progress of the lesions . ( 3 ) There was a
difference of the appearance rate of remaining lesion in lungs in two groups ( ≥40 ages and < 40 ages) .
Conclusion ( 1 ) Residual lesions were found in 26. 0% patients with SARS in 24 months after onset ,
which appeared mainly as the ground-glass lesions with pulmonary interstitial hyperplasia and fibrosis . ( 2) If
the progress was rapid and long, the extent of lesions was extensive and ages was more than 40 in their
suffering stage, the pulmonary lesions would be remained frequently.
【Key wor ds 】 Severe acute respiratory syndrome; Tomography, X-ray computed; Follow-up
studies

嚴重急性呼吸綜合征患者肺部殘留.rar