摘要
目的 探讨糖皮质激素在治疗严重急性呼吸综合征 (SARS)的作用、具体方法、用量及对血象的影响。方法 收集太原市第四人民医院收治的SARS病人使用激素 (甲泼尼龙 )者 36例 ,统计激素治疗的时间、剂量 ,临床症状改善时间 ,胸片开始吸收的时间 ,减量的时间 ,使用疗程及血白细胞在使用前后的情况。同时收集不使用激素的 18例SARS病人血白细胞情况并对其治疗前后进行比较。结果 36例应用激素剂量为 80～ 2 4 0mg/d ;平均疗程 (17.9± 8.3)d ;从发病到应用激素的时间与从发病到X线病灶开始吸收的时间呈正相关 ,r =0 .5 86 8(P <0 .0 1) ;临床症状改善的时间平均为 (3.3± 2 .0 )d ;激素减量的平均时间为 (4 .7± 2 .3)d ;应用激素后白细胞升高 (P <0 .0 1) ,不用激素者无 1例白细胞升高 ;3例出现副作用 ,应用激素疗程均超过 4周 ;2例死亡患者死亡原因之一与激素的应用有关。结论 ①严格掌握激素应用的适应证 ;②宜早期应用激素 ;③甲泼尼龙剂量建议为 80～ 2 4 0mg/d ,具体用量根据病情而定 ;
Objective To explore the effects of glucocorticoid (methylprednisolone) on patients with SARS ,its practical dosage and hemographic changes. Methods Clinical data of 36 patients with SARS treatedwith glucocorticoid (methylprednisolone) were studied including the time of using the hormone and its dosage, time of clinical improvement ,time of lung lesionabsorption shown by chest film,time of the reduction of glucocorticoid and changes of white cell count before and after using the drug. And changes of white cell count were collected from 18 patients with SARS treated without hormone. Dataof both groups were compared. Results In 36 patients,the dosage was 80～240 mg/d. Treatment time was (17.9±8.3)d. Time from attack to use of drug and time from attack to lung lesion absorption shown by chest film were in positive correlation, r=0.586 8(P<0.01). The time of clinical symptom improvement was (3.3±2.0) d. The time of drug reduction was (4.7±2.3) d. White cell count increased after the drug treatment (P<0.01),but it did not in patients without hormone. Side effects appeared in 3 patients. The drug-using period was>4 weeks in all the patients. The reason of two dead patients was connected to timeand dosage of used hormone. Conclusion ①The use of glucocorticoid must bestrictly controlled according to its indication. ②The drug should be used as early as possible.③The suggested dose of methylprednisolone is 80～240 mg/d,andthe practical dosage should depend on the course of disease.④The early reasonable use of the drug may decrease fatality rate of the patients.
出处
《山西医科大学学报》
CAS
2004年第2期137-139,共3页
Journal of Shanxi Medical University
