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目的研究严重急性呼吸综合征(SARS)患者康复期的肺功能动态变化状态。方法对68例康复期SARS患者在出院1、2、3及6个月进行随访,了解其症状、体征和基础疾病,测定肺功能、T淋巴细胞亚群、SARS病毒抗体IgG、血气分析,作胸部高分辨CT。对肺功能各项指标与其他指标作相关性分析。结果所有患者的SARS病毒抗体IgG为阳性。出院1个月时44例有肺功能异常(674%),43例为轻、中度异常(632%),41例有弥散障碍(603%),其中单纯弥散障碍31例(456%),6个月后仍有16例(235%)存在弥散障碍。出院3个月的TLCO较出院1个月明显好转(P<005),出院3个月与6个月的TLCO差异无显著性(P>005)。出院1个月的患者中有35例(515%)胸部CT表现异常,出院3个月的CT变化较出院1个月明显好转(P<005),出院3个月与6个月时的CT变化无显著性差异(P>005)。多元逐步回归分析显示,TLCO与CT异常改变有明显相关性。结论SARS患者康复早期存在不同程度的肺功能损害,但多数为轻、中度异常,肺功能损害以弥散下降为主。出院3个月肺功能明显好转,出院6个月与出院3个月比较肺功能改善无明显差异。
Objective To study the dynamic changes of pulmonary function in patients with severe acute respiratory syndrome (SARS) during convalescence. Methods Sixty-eight patients with convalescent SARS were followed up for 1, 2, 3, and 6 months after discharge to understand the symptoms, signs and underlying diseases, to determine the lung function, T lymphocyte subsets, SARS antibody IgG, blood gas analysis Chest high resolution CT. Correlation analysis of various indexes of lung function and other indexes. Results All patients had positive IgG antibodies against SARS. Forty-four patients had an abnormal lung function (674%) at 1 month after discharge, 43 were mild to moderately abnormal (632%), 41 had disseminated (603%), of which 31 (456% Six months later (235%) there were still diffuse obstacles. There was no significant difference in TLCO between 3 months and 6 months after discharge (P> 005). Thirty-five patients (515%) discharged from the hospital had abnormal chest CT findings. CT changes at 3 months after discharge were significantly better than those at 1 month after discharge (P <005), CT at 3 and 6 months after discharge There was no significant difference (P> 005). Multiple stepwise regression analysis showed significant correlation between TLCO and CT abnormalities. Conclusions There are different degrees of pulmonary dysfunction in SARS patients at early stage of rehabilitation, but most of them are mild to moderate abnormalities with the decrease of pulmonary function. Three months after discharge, pulmonary function improved significantly. There was no significant difference in pulmonary function between 6 months after discharge and 3 months after discharge.