【摘要】 目的 :通过观察SARS患者临床治愈后肺功能的变化 ,了解SARS患者是否遗留有肺功能的长期损害。方法 :对 82例SARS患者 (实验组 )出院 3个月后进行临床随访及肺功能检测 ,同时测定 2 8例健康人的肺功能作为对照组 ,对结果进行分析。结果 :肺功能检测发现一氧化碳弥散量 (DLCO % )实验组均值为 78.4 %± 17.4 % ,对照组为 93.8%± 13.6 % (P <0 .0 1)。实验组中有 4 6例 (5 6 .1% )存在弥散功能障碍 (DLCO % <80 % ) ,37例 (45 .1% )有小气道功能障碍 ,2 8例 (34.1% )残总比增加 (RV/TLC >35 % ) ,9例 (10 .9% )有限制性通气功能障碍。按照患者住院期间病情最重时胸片的改变 (以肺部斑片状影占据肺叶的范围为标准 ) ,将患者分为轻、中、重 3组 ,病情轻重程度与出院后 3个月肺弥散功能损害呈正相关。重症患者使用机械通气治疗组与未使用机械通气治疗组肺功能损害差异不明显。结论 :SARS患者治愈出院 3个月后 ,部分患者遗留有肺功能损害 ,主要以弥散功能障碍为主 ,其次为小气道阻塞和残气增加 ,少数有限制性通气功能障碍。更多还原

【Abstract】 Objective: From the observation of pulmona ry function changes in clinical cured patients with SARS,we aimed to understand if there were longtime pulmonary function damages. Methods: Pulmona ry function tests and follow-up of clinical features were performed in 82 SARS p atients three months after their discharge from hospital (study group). At the s ame time, pulmonary function of 28 healthy persons were confronted(control group ). Results: Pulmonary function showed that the mean diffusing ca pacity of CO(DLCO) was 78.4±17.4% in study group and 93.8±13.6% in control gro up(P<0.01). Diffusing function decreased in 46(56.1%) cases in study group( DLCO%<80%), small airway function abnormality in 37(45.1%) cases, residual volu me increased (RV/TLC>35%) in 28(34.1%) and restrictive ventilation function abn ormality in 9(10.9%) cases. According to their X-ray changes( based on the parts of pathy shadows in lung fields) during the hospital, the study group are divid ed themselves into three subgroups: mild, moderate and severe. There was a posit ive correlation between the severity of the disease and the diffusing function d amage 3 month after hospital dischaoge. There was not obvious difference in the pulmonary function damage between the severe patients treated with mechanical ve ntilation and those without mechaical Vontilation. Conclusion: Parts of SARS patients had left pulmonary function damage three months after their discharg from hospital, mainly with diffusing capacity abnormality, second ary small airway obstruction and residual volume increase. A few cases had restr ictive ventilation function abnormality.更多还原