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目的 了解SARS康复者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 2 93例北京地区SARS患者康复后半年内定期进行SARS冠状病毒特异性IgG抗体、肺功能和胸部影像学检查 ,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 2 93例中有 2 33例SARS冠状病毒特异性IgG抗体阳性 (79 5 % ) ,且半年内抗体水平有逐渐下降趋势。特异性IgG抗体阳性的康复者中 5 6例合并有肺部影像学异常 ,5 7例 (2 4 5 % )合并有弥散功能(DLCO)异常 ,其中 4 0例半年内进行了 3次以上肺功能检查 ,发现其肺功能和肺部影像学变化均有不同程度的改善。 6 0例进行股骨头磁共振检查的康复者中有 1 5例发现有股骨头缺血性坏死改变 (2 5 % )。结论 临床诊断为SARS的患者中可能有部分为误诊病例 ,SARS康复者合并的肺纤维化改变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 SARS-CoV-specific IgG antibodies, lung function and lung imaging in SARS patients. Methods2 93 SARS-SARS patients in Beijing were routinely tested for SARS-CoV-specific IgG antibodies, lung function and chest imaging within six months after the rehabilitation. Patients with pulmonary dysfunction were regularly reviewed for lung function and chest radiography. Observe the recovery of lung function. Some patients with osteoarthritis were examined by femoral head MRI. RESULTS: Of 233 cases, 2 33 were positive for SARS-CoV-specific IgG antibodies (79 5%), and antibody levels gradually decreased within 6 months. Fifty-six (24.5%) patients with abnormal IgG were found to have abnormal lung imaging in 56 patients who had been diagnosed with IgG antibodies. DLCO abnormalities were found in 57 patients (40%), of whom 40 Functional tests found that the lung function and lung imaging changes have varying degrees of improvement. Fifty-six of 60 patients who underwent MRI examination of the femoral head showed a change in avascular necrosis of the femoral head (25%). Conclusion Some of the patients with clinically diagnosed SARS may be misdiagnosed. The combined changes of pulmonary fibrosis in SARS patients may be obviously absorbed and improved within a certain period of time, and some of the patients recovered with avascular necrosis of the femoral head.