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目的了解糖皮质激素(简称激素)使用及严重急性呼吸综合征(SARS)感染本身对SARS康复者股骨骨髓转换的影响。方法观察148例SARS[42例未用激素(未用激素组)、106例使用激素(使用激素组)]康复医务人员及97名年龄与性别匹配的正常对照者(正常对照组)磁共振成像(MR I)上股骨近端骨髓的分布,并在T1加权成像上测量并比较未用激素组、使用激素组的SARS康复者及正常对照组之间骨髓转换指数的差异。结果148例中106例使用激素的SARS康复者,4例出现股骨头缺血坏死,2例股骨骨髓水肿,1例股骨颈骨梗死。正常对照组、未用激素组及使用激素组SARS康复者骨髓转换指数分别为(79.4±6.8)%、(86.9±7.4)%、(88.6±5.9)%,使用激素组与未用激素组、使用激素组与正常对照组、未用激素组与正常对照组的比较,P值分别为<0.05、<0.01、<0.01,差异均有统计学意义。结论激素的应用可促进股骨近端骨髓黄骨髓化,而SARS感染本身也可导致股骨颈红骨髓过度转换为黄骨髓。
Objective To investigate the effect of glucocorticoid (SARS) infection and severe acute respiratory syndrome (SARS) infection on femoral bone marrow conversion in patients with SARS. Methods 148 cases of SARS were observed, including 42 cases of non-hormones (106 cases without hormones) and 106 cases of hormones (with hormones) and 97 cases of age-sex matched controls (normal control group), magnetic resonance imaging (MR I) on the proximal femur bone marrow distribution and measurement and comparison of T1-weighted imaging of bone marrow conversion index differences between hormone-free group, the use of hormones in SARS patients and normal control group. Results Among the 148 cases, 106 cases of SARS recovered with hormones, 4 cases of avascular necrosis of the femoral head, 2 cases of femoral bone marrow edema and 1 case of femoral neck bone infarction. The bone marrow conversion index of SARS patients in control group, non-use hormone group and those who used hormone group were (79.4 ± 6.8)%, (86.9 ± 7.4)% and (88.6 ± 5.9)%, respectively, The use of hormone group and normal control group, no hormone group compared with the normal control group, P values were <0.05, <0.01, <0.01, the differences were statistically significant. Conclusion The application of hormones can promote bone marrow yellow bone marrow of proximal femur, and SARS infection itself can lead to excessive conversion of femoral neck red bone marrow into yellow bone marrow.