Shen Jun, Liang Bi-ling, Zeng Qing-si, Chen Jian-yu, Liu Qing-yu, Chen Rong-chang, Zhong Nan-shan
Department of Radiology, Second Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510120, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2006 Mar;29(3):189-93.
To determine the effect of corticosteroid treatment and severe acute respiratory syndrome (SARS) infection itself on the marrow conversion in the proximal femoral marrow in the recovered patients of health care workers with SARS.
The distribution of proximal femoral marrow on MR imaging of 148 health care workers with recovered SARS including 106 cases treated with varied dosage of steroids and 42 cases without steroid, and 97 age and sex matched health adults as controls were observed. The index of marrow conversion (signal intensity of the femoral neck and intertrochanteric area divided by signal intensity of the greater trochanter multiplied by 100%) was quantitatively measured and compared between SARS patients treated with steroid and without steroid and the normal control group.
In 106 cases treated with steroid of the 148 health care workers, femoral head osteonecrosis was found in 4 cases, bilateral femoral marrow edema in 2 cases, femoral marrow infarction in 1 case. The index of marrow conversion in the normal controls, in SARS patients treated without and with steroids was (79.4 +/- 6.8)%, (86.9 +/- 7.4)%, (88.6 +/- 5.9)%, respectively. There was significantly statistical difference between groups (P < 0.05).
In addition to fat conversion in the proximal femoral marrow due to steroid treatment, the infection of SARS itself may promote an excessively conversion of the red marrow to yellow marrow of the femoral neck in SARS patients.
确定皮质类固醇治疗及严重急性呼吸综合征(SARS)感染本身对SARS康复医护人员近端股骨骨髓转化的影响。
观察148例SARS康复医护人员近端股骨骨髓在磁共振成像上的分布情况,其中106例接受了不同剂量类固醇治疗,42例未接受类固醇治疗,同时观察97例年龄和性别匹配的健康成年人作为对照。定量测量骨髓转化指数(股骨颈和转子间区域的信号强度除以大转子的信号强度再乘以100%),并比较接受类固醇治疗和未接受类固醇治疗的SARS患者与正常对照组之间的差异。
在148例接受类固醇治疗的医护人员中,106例中有4例出现股骨头坏死,2例出现双侧股骨骨髓水肿,1例出现股骨骨髓梗死。正常对照组、未接受类固醇治疗的SARS患者和接受类固醇治疗的SARS患者的骨髓转化指数分别为(79.4±6.8)%、(86.9±7.4)%、(88.6±5.9)%。组间差异有统计学意义(P<0.05)。
除了类固醇治疗导致近端股骨骨髓脂肪转化外,SARS感染本身可能促使SARS患者股骨颈红骨髓过度转化为黄骨髓。