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目的探讨SARS死亡病例胸部X线表现。方法回顾性分析11例SARS死亡病例的胸部X线表现,并与249例治愈病例做对比分析。结果11例SARS死亡病例的胸部主要X线表现为:斑片状影10例(90.90%),大片状影8例(72.73%),大范围肺实变8例(72.73%),间质改变10例(90.90%),磨玻璃样改变9例(81.82%),弥漫性病变11例(100%),双肺受累9例(81.82%)。对比分析显示大片状影、大范围肺实变、磨玻璃样改变、弥漫性病变这4种X线表现在死亡病例与治愈病例的差异具有统计学意义(P<0.01)。结论大片状影、大范围肺实变、磨玻璃样改变、弥漫性病变、双肺受累,尤其是大范围肺实变和弥漫性病变是SARS死亡病例的主要X线表现。绝大多数SARS死亡病例死亡前最后一次胸片显示双侧肺野广泛的内有支气管气像的磨玻璃样改变。
Objective To investigate the chest X-ray findings of death from SARS. Methods The chest X-ray findings of 11 SARS death cases were retrospectively analyzed and compared with that of 249 cases. Results The main chest radiographs of 11 SARS death cases were as follows: patchy image in 10 cases (90.90%), large patchy film in 8 cases (72.73%), extensive lung consolidation in 8 cases (72.73%), Ten cases (90.90%) were changed. There were 9 cases (81.82%) of ground glass changes, 11 cases (100%) of diffuse lesions and 9 cases (81.82%) of bilateral lung involvement. The comparative analysis showed that there were significant differences in the four X-ray manifestations between large and small pulmonary lesions, extensive lung consolidation, ground glass-like changes and diffuse lesions between the dead and the cured cases (P <0.01). Conclusions The large radiographs, extensive lung consolidation, ground glass changes, diffuse lesions and bilateral lung involvement, especially the extensive lung consolidation and diffuse lesions, are the main radiological manifestations of SARS deaths. The vast majority of SARS deaths before the death of the chest X-ray showed widespread bronchial changes in both lung fields.