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目的 通过对SARS患者在干预条件下胸片的研究 ,揭示SARS肺部炎症演变规律和动态分布特征。方法 对参加国家科技部“十五”86 3重大项目“中西医结合治疗SARS临床研究”的北京地区 11家医院入组患者的胸片 ,通过进行数字化采集 ,定量评判方法统一判读 ,建立SARS胸片数据库 ,再进行统计分析和描述。结果 对 36 1例SARS患者的 15 6 1张胸片的研究表明 ,①胸片总积分与肺部炎性病灶的动态分布呈双峰形 ,普通型第 1峰出现在发病第 16天 ,重型在发病第 13天 ;第 2个小的、短暂的高峰 ,普通型出现在发病第 2 5天 ,重型在发病第 19天以后进入恢复的平台期。②SARS的肺部炎症病灶多出现在中、下肺野 ,以下肺居多 ;发病 8～ 14d ,右下肺多于左下肺 ,发病15d以上左中肺多于右中肺 ,经统计学检验有显著性差异。③SARS肺部炎症的轻重程度随着年龄的增长呈现愈加严重的趋势。结论 SARS患者的肺部炎症随着病程的进展 ,其动态演变和病变部位的分布呈现出一定的规律性 ;不同性别和年龄的SARS患者 ,肺部炎症具有轻重程度上的差异性。
OBJECTIVE: To study the evolution and dynamic distribution characteristics of lung inflammation in SARS through the study of the chest radiograph in SARS patients under the interventional conditions. Methods Thoracic radiographs of 11 patients who participated in the SARS clinical trial of Integrative Chinese and Western Medicine in the “Tenth Five-Year Plan” of the “Tenth Five-Year Plan” of the “Tenth Five-Year Plan” of National Ministry of Science and Technology were collected and evaluated quantitatively to establish SARS chest Film database, and then for statistical analysis and description. Results Of 361 cases of SARS patients with 15 6 1 chest radiographs showed that: ① the total chest radiograph and pulmonary inflammatory lesions showed a bimodal dynamic distribution of the first peak of the common type in the onset of the first 16 days, heavy The incidence of the first 13 days; the second small, short-lived peak, the common type appeared in the first 25 days of onset, heavy in the 19th day after the onset of recovery into the plateau. ②SARS lung inflammation lesions appear in the middle and lower lung fields, most of the following lungs; onset 8 ~ 14d, lower right lung more than the lower left lung, more than 15d onset of left middle lung more than the right middle lung, the statistical test was significant Sex differences. ③ The severity of SARS pulmonary inflammation presents a more serious trend with age. Conclusions The lung inflammation of patients with SARS progresses with the course of the disease, and the dynamic evolution and the distribution of the lesions show some regularity. The SARS patients with different sexes and ages have the severity of lung inflammation.