论文部分内容阅读
目的对北京地区临床诊断的严重急性呼吸综合征(SARS)康复者出院后进行定期临床随访,动态观察SARS冠状病毒特异性IgG抗体、肺功能和肺部影像学的变化。方法383例SARS患者康复后1年内定期进行SARS冠状病毒特异性IgG抗体、肺功能和肺部影像学检查,合并有肺弥散功能异常的康复者定期进行肺功能和胸部影像学复查,动态观察肺功能的恢复情况。部分合并有骨关节疼痛的患者进行股骨头磁共振检查。结果383例中有311例SARS冠状病毒特异性IgG抗体为阳性(812%),1年内动态观察康复者血清特异性抗体有明显下降。特异性IgG抗体为阳性的康复者中有85例(273%)合并有弥散功能(DLCO)异常,67例合并有肺部影像学异常。其中40例DLCO异常的康复者1年内肺功能和肺部影像学动态观察均有不同程度改善。78例进行股骨头磁共振检查的康复者中18例发现股骨头缺血性坏死改变(231%)。结论临床诊断为SARS的康复者中可能有部分为误诊病例,SARSCoVIgG抗体水平在出院后1年内逐渐降低,合并有肺纤维化改变的SARS康复者在一定时期内可明显吸收和好转,部分康复者合并有股骨头缺血性坏死改变。
Objective To investigate the changes of clinical SARS-coronavirus (SARS-CoV) -specific IgG antibodies, pulmonary function and pulmonary imaging in clinically diagnosed SARS patients in Beijing after regular clinical follow-up. Methods A total of 383 SARS patients underwent SARS-Coronavirus-specific IgG antibody, lung function and pulmonary imaging examination within one year after rehabilitation. The patients with pulmonary dysfunction underwent routine pulmonary function and chest radiographic review. Functional recovery. Some patients with osteoarthritis were examined by femoral head MRI. Results Among the 383 cases, 311 cases of SARS-CoV-specific IgG antibodies were positive (812%). Serum-specific antibodies were significantly decreased in the 1-year dynamic observation. Eighty-five (273%) of the patients who were positive for specific IgG antibody had diffuse functional (DLCO) abnormalities, and 67 patients had abnormal pulmonary imaging. Among 40 cases of DLCO abnormalities, the dynamic changes of lung function and pulmonary radiology within one year showed different degrees of improvement. Seventy-eight of the 78 patients who underwent MRI examination of the femoral head showed a change in ischemic necrosis of the femoral head (231%). Conclusions Some of the patients diagnosed as SARS may be misdiagnosed. The level of SARSCoVIgG antibody decreased gradually within one year after discharge. SARS patients with pulmonary fibrosis may be significantly absorbed and improved within a certain period of time. Some patients Combined with avascular necrosis changes.