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A Correlative Study of CT Finding of in Patients With Severe Acute Respiratory Syndrome (SARS) in the Recovery Phase and the Result of Pulmonary Function Test. and Expression of Lymphocytes Subsets<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
张伟宏 金征宇 王沄 梁继祥 有慧 张立仁
中国协和医科大学中国医学科学院 北京 100730
北京协和医院
*放射科 ＃检验科 感染内科
呼吸内科 急诊科
ABSTRACT
Objective: To evaluate the appearance of CT in patients with severe acute respiratory syndrome(SARS) in the recovery phase , and to study the correlation with pulmonary function and expression of lymphocytes subsets.
Methods: 100 patient confirmed SARS accepted examination in our hospital from June to August in 2003. Transverse thin-section CT scan and pulmonary function test were obtained at mean 87.42 days (52-125days)after admission and 54.31 days(32-101days) after discharged. Lab examination of blood cell was obtained at the same week.We summarized the result of serum SARS antibody and analyzed expression of lymphocytes and its subsets. We quantified the CT appearances of pulmonary parenchymal abnormality including distribution and extent of involvement, and obtain CT visual score in four levels: the aortic arch, the tracheal carina, the pulmonary venous confluence, and the dome of right diaphragm, and to find the correlation with the results of pulmonary function tests.
Results: 1) Among 100 patients with SARS during convalescent phase cases, serum SARS antibody positive were found in 73 patients; 47 patients had abnormal CT appearance in the recovery phase. 100 patients were divided into four group: group1 (22 cases), which had negative SARS antibody and normal finding in CT; group2(31 cases), which had positive SARS antibody and normal finding in CT;group3 (42 cases), which had positive SARS antibody and abnormal findings in CT; group4(5 cases), which had negative SARS antibody and normal finding in CT. 2) One-way ANOVA analysis showed that only DLco% among pulmonary function parameters had statistical significance among groups. DLco% in group 3 had statistic difference with group2 or group1 (t=4.613, P<0.001; t=3.473, P=0.001).But there was not statisticalsignificance of DLco%...between group2 and group1.(t=1.907, P=0.063).3) There was no statistical significance of leukocyte count and of lymphocyte subsets count among groups. 4) Among 73 patients who had positive SARS antibody, 42 patients had abnormal findings in thin-section CT, including residual ground-glass opacification and reticular shadow. CT visual score in group3, which was used to quantity the extension and extent of abnormal finding in CT, had correlation with DLco%( r=-0.712, P<0.001).
Conclusion: CT scans showed that 42.5% SARS patients had recuperated their health in three months after the initial hospital admission. CT visual score can quantitatively evaluate the abnormal appearance of lungs, and also indicates pulmonary function.
Key words: Severe Acute Respiratory Syndrome (SARS); Tomography, X-ray Compute; Respiratory function tests; Lymphocyte Subset |
