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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 (2 6例 )及正常对照组 1 2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
Objective To study the changes of lung diffuse ability (DL), alveolar capillary membrane diffusivity (Dm) and alveolar capillary blood volume (Vc) in severe acute respiratory syndrome (SARS) and to explore the pathophysiological mechanism of pulmonary diffuse dysfunction. Methods SARS (26 cases) and normal control group (12 cases) were used to measure the DL at different oxygen partial pressures at rest. Dm and Vc were calculated according to Roughton and Forster methods. Results The DLco of SARS group was significantly lower than that of the control group, and the Dm and Vc of group A were significantly lower than those of the control group. The more serious pulmonary lesions were, the more severe the diffuse pulmonary function impairment and the lower or higher residual gas volume (RV) increase. Conclusions There are not only Dm but also Vc changes in patients with SARS. The determination of Dm and Vc is beneficial for the detection of SARS pulmonary lesion, and it can be used to determine the cause of DL decline and the degree of lesion. It is an important and sensitive indicator of lung diffuse function test