Yao Wanzhen, Chen Yahong, Zhang Liqiang, Wang Xiaohong, Sun Yongchang, Sun Wei, Han Jiangli, Zhang Fuchun, Zheng Yaan, Sun Bozhang, He Bei, Zhao Mingwu
Peking University, Third Hospital, Beijing 100083, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2003 May 31;35 Suppl:26-8.
To investigate the effect of glucocorticosteroids on severe acute respiratory syndrome (SARS) and chest X ray changes after discontinuation of glucocorticosteroids treatment.
To retrospectively study the clinical characteristics of 5 cases with SARS and chest X ray changes after discontinuation of glucocorticosteroids.
5 cases were medical workers and had exposure to SARS patients. The incubation periods were 2 to 7 days. They had high fever from the onset of the disease. There were lung infiltrates 1 to 6 days after fever and then methylprednisolone was given to them. Two or three days after glucocorticosteroids treatment, clinical symptoms in these patients were disappeared. The clinical symptoms in case 1, cases 2, case 4 and case 5 weren't deteriorated after discontinuation of methylprednisolone while the presentation in chest X ray was progressed 3-6 days later. No more methylprednisolone was given to the patients and the infiltrates in chest X ray was gradually absorbed in 5-11 days. The temperature in case 3 was elevated again and the shadow in chest X ray was progressed after discontinuation of methylprednisolone due to the low dosage of glucocorticosteroids. When the dosage of methylprednisolone was increased, the temperature tended to be normal and the lung infiltrates began to absorb gradually.
For the patients with non-severe SARS, if the symptoms were disappeared after discontinuation of glucocorticosteroids, the lung shadow may be progressed. we can closely observe the condition of the disease and no more glucocortisteroids needed to be given to the patients. The lung shadow could be absorbed gradually.
探讨糖皮质激素对严重急性呼吸综合征(SARS)的影响以及停用糖皮质激素治疗后的胸部X线变化。
回顾性研究5例SARS患者的临床特征及停用糖皮质激素后的胸部X线变化。
5例均为医务人员,有SARS患者接触史。潜伏期为2至7天。发病即高热,发热1至6天后出现肺部浸润影,随后给予甲泼尼龙治疗。糖皮质激素治疗2至3天后,患者临床症状消失。停用甲泼尼龙后,1例、2例、4例和5例患者临床症状未恶化,但胸部X线表现于3至6天后进展。未再给予甲泼尼龙,胸部X线浸润影于5至11天逐渐吸收。3例患者因糖皮质激素用量低,停用甲泼尼龙后体温再次升高,胸部X线阴影进展。增加甲泼尼龙用量后,体温趋于正常,肺部浸润影开始逐渐吸收。
对于非重症SARS患者,停用糖皮质激素后症状消失,肺部阴影可能进展,可密切观察病情,无需再给予糖皮质激素,肺部阴影可逐渐吸收。