臺灣嚴重急性呼吸道症候群倖存者的追蹤研究

Long-term Follow-up of Survivors of Severe Acute Respiratory Syndrome (SARS) in Taiwan

目的：本研究的目的在探討臺灣的SARS個案在疾病治癒後之健康情形。方法：共有67位SARS倖存者在臺北市立聯合醫院接受2次的追蹤檢查（2006年及2010年），檢查項目包括血球生化抽血、肺功能、特殊檢查（胸部與骨盆影像）及骨質密度。結果：總共67位SARS倖存者（平均年齡45.4±12.3），主要以女性（73.1%）成年人為主，職業別有近八成為（77.6%）非醫護人員。在SARS倖存者的第七年追蹤，我們發現仍有接近三成有肺部纖維化，近一成有股骨頭壞死；七年的追蹤顯示肺部纖維化及肺功能限制性障礙，異常人數均有明顯的減少。進一步針對職業別、年齡別與特殊檢查交叉分析，結果顯示肺功能限制性障礙、肺部纖維化、股骨頭缺血性壞死與職業及年齡別均無顯著關聯。僅「運動心電圖陽性」與職業及年齡別有相關性的趨勢（p=0.05）。結論：在SARS倖存者的第七年追蹤，我們發現仍有三成的肺部纖維化及一成的股骨頭壞死，我們應持續提供肺功能及股骨頭影像檢查，以便早期治療可能的併發症。

Objective: The objective of this study was to determine the long-term outcome for SARS survivors in Taiwan. Methods: A total of 67 SARS survivors at Taipei City Hospital were followed with serial health examinations of blood, pulmonary function, chest/pelvic radiography, chest high-resolution CT (HRCT), magnetic resonance imaging (MRI) of the pelvis and bone density scan 3-and 7years after onset of their disease. Results: Serial assessments were completed for the 67 SARS survivors, 52 (77.6%) of whom were non-health care workers. Their mean age was 45.4±12.3 and the majority were female (73.1%). Among these SARS survivors, 18 (26.9%) had pulmonary fibrosis and 7 (10.4%) had avascular necrosis of the femoral head. We found slight reductions in both pulmonary fibrosis and restricted lung capacity at the 7-year follow-up compared to the 3-year one. Restricted lung capacity, pulmonary fibrosis, and avascular necrosis of the femoral head were not related to occupation and age in our analysis; however, a 'positive treadmill exercise test' was related to both occupation and age (p=0.05). Conclusions: Most SARS survivors recovered physically but some still showed restricted lung capacity and avascular necrosis of the femoral head 7 years after onset of the disease. Further follow-up is needed to determine if these deficits persist.