严重急性呼吸综合征：影像学与临床参数之间的关系。

Severe acute respiratory syndrome: relationship between radiologic and clinical parameters.

作者信息

Ooi Clara G C, Khong Pek L, Lam Bing, Ho James C M, Yiu Wai C, Wong Wai-Man, Wang Teresa, Ho Pak L, Wong Poon C, Chan Raymond H, Lam Wah K, Lai Kar N, Tsang Kenneth W T

机构信息

Department of Diagnostic Radiology, University of Hong Kong, Rm 405, Block K, Queen Mary Hospital, Pokfulam Road, Hong Kong Special Administrative Region, China.

出版信息

Radiology. 2003 Nov;229(2):492-9. doi: 10.1148/radiol.2292030736. Epub 2003 Oct 2.

DOI:10.1148/radiol.2292030736

PMID:14526098

Abstract

PURPOSE

To quantify severity of severe acute respiratory syndrome (SARS) on chest radiographs and to determine its relationship with clinical parameters.

MATERIALS AND METHODS

Forty patients (mean age, 42.90 years +/- 14.01 [SD]; median age, 41.5 years; age range, 25-82 years) with clinically diagnosed SARS were evaluated. Heart rate, oxygen saturation, temperature, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were recorded daily. Severity of lung changes on chest radiographs was scored according to percentage of involved lung. Radiographic scores at days of admission, treatment, and maximal radiographic score were extracted for statistical analysis with clinical parameters. Time to maximal radiographic score from admission and days between onset and beginning of treatment were determined. Correlations between radiographic and clinical parameters were evaluated with Spearman rank correlation. Sex differences with respect to clinical and radiographic parameters were evaluated with Mann-Whitney test.

RESULTS

Median chest radiographic scores peaked 5 days after beginning of treatment before they declined. Maximal and treatment radiographic scores were inversely related to oxygen saturation (r = -0.67, P <.001; r = -0.35, P =.03). Admission radiographic score was correlated with admission AST level (r = 0.53, P =.003); treatment radiographic score, with treatment ALT and AST levels (r = 0.43, P =.007; r = 0.42, P =.019); and time to maximal radiographic score, with AST level at maximal radiographic score (r = -0.45, P =.006), admission radiographic score (r = -0.55, P <.001), treatment radiographic score (r = -0.58, P <.001), and admission ALT and AST levels (r = -0.44, P =.007; r = -0.58, P =.001). Treatment delay was associated with AST level at maximal radiographic score (r = 0.53, P =.001), treatment radiographic score (r = 0.60, P <.001), and time to maximal radiographic score (r = -0.36, P =.02). No sex differences occurred with respect to radiographic and clinical parameters (P >.05).

CONCLUSION

Severity of lung abnormalities quantified on chest radiographs correlates with clinical and laboratory parameters.

摘要

目的

量化严重急性呼吸综合征（SARS）胸部X线片的严重程度，并确定其与临床参数的关系。

材料与方法

对40例临床诊断为SARS的患者（平均年龄42.90岁±14.01[标准差]；年龄中位数41.5岁；年龄范围25 - 82岁）进行评估。每天记录心率、血氧饱和度、体温以及丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）水平。根据肺部受累百分比对胸部X线片上的肺部改变严重程度进行评分。提取入院时、治疗时的X线片评分以及最大X线片评分，用于与临床参数进行统计分析。确定从入院到最大X线片评分的时间以及发病到开始治疗的天数。采用Spearman等级相关评估X线片参数与临床参数之间的相关性。采用Mann - Whitney检验评估临床和X线片参数方面的性别差异。

结果

胸部X线片评分中位数在治疗开始后5天达到峰值，随后下降。最大和治疗时的X线片评分与血氧饱和度呈负相关（r = -0.67，P <.001；r = -0.35，P =.03）。入院时X线片评分与入院时AST水平相关（r = 0.53，P =.003）；治疗时X线片评分与治疗时ALT和AST水平相关（r = 0.43，P =.007；r = 0.42，P =.019）；达到最大X线片评分的时间与最大X线片评分时的AST水平相关（r = -0.45，P =.006）、入院时X线片评分相关（r = -0.55，P <.001）、治疗时X线片评分相关（r = -0.58，P <.001）以及入院时ALT和AST水平相关（r = -0.44，P =.007；r = -0.58，P =.001）。治疗延迟与最大X线片评分时的AST水平相关（r = 0.53，P =.001）、治疗时X线片评分相关（r = 0.60，P <.001）以及达到最大X线片评分的时间相关（r = -0.36，P =.02）。在X线片和临床参数方面未发现性别差异（P >.05）。