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目的 探讨严重急性呼吸综合征(SARS)患者应用皮质激素治疗的疗效及不良反应。方法 35例SARS患者在综合治疗基础上应用甲基泼尼龙治疗(80～4 0 0mg/d ,分2次静滴) ,治疗期间观察胸部X线片,血常规、生化、电解质的变化。结果 35例应用皮质激素治疗,17例普通型均治愈(有效率10 0 % ) ;14例重型中治愈12例(治愈率85 . 71% ) ,2例转为极重型后1例死亡;4例极重型治愈3例(有效率75 .0 0 % ) ;35例中合并二重感染7例;发生精神错乱1例、高血糖1例、高血压1例、电解质紊乱1例。结论 皮质激素治疗SARS可明显减轻肺部炎症,减轻中毒症状。病情严重的SARS患者短期应用激素是必要和安全的。
Objective To investigate the efficacy and adverse reactions of corticosteroids in patients with severe acute respiratory syndrome (SARS). Methods Thirty-five patients with SARS were treated with methylprednisolone (80-400 mg / d, intravenous infusion 2 times) on the basis of comprehensive treatment. The changes of chest X-ray, blood routine, biochemistry and electrolyte during the treatment were observed. Results Of the 35 cases treated with corticosteroids, 17 cases were cured with common type (effective rate was 10%), 12 cases were cured in 14 cases (85.71%), 2 cases were extremely severe and 1 case died. 4 Three cases were extremely severe (effective rate was 75.0%). Seven cases were complicated by secondary infection in 35 cases. One case was delirium, one case was hyperglycemia, one case was hypertension and one case was electrolytes disorder. Conclusion The treatment of SARS by corticosteroids can obviously reduce lung inflammation and alleviate the symptoms of poisoning. Short-term use of hormones in SARS patients is necessary and safe.