严重急性呼吸综合征感染后骨坏死临床研究  

Osteonecrosis in Post-SARS Patients: A Clinical Study

作　　者：韩玉坤[1] 周先志[1] 曾珍[1] 张海陵[1] 耿华[1] 王华明[1] 牟劲松[1] 季伟[1] 李志伟[1] 张效东[1] 张晓峰[1] 王海滨[1] 毛远丽[1] 陈菊梅[1] 

机构地区：[1]解放军302医院,北京100039

出　　处：《中华医院感染学杂志》2005年第5期481-483,i001,共4页Chinese Journal of Nosocomiology

基　　金：国家高技术研究发展计划(863计划)(2003AA208106)

摘　　要：目的　探讨导致严重急性呼吸综合征(SARS)感染后骨坏死相关因素,提高SARS诊断、治疗水平,预防骨坏死发生。方法　对住院临床诊断SARS的80例患者出院后跟踪6 个月随访;检测血液生化,观察不同时期症状,总结SARS感染后骨坏死发生与激素治疗每天最大剂量、疗程、治疗全程总量和临床相关因素。结果　SARS感染后骨坏死跟踪样本发生率26.3%,以医务人员居多;糖皮质激素(甲泼尼龙)对骨坏死的形成有辅助作用,甲泼尼龙治疗全程总剂量>6 000 mg和治疗疗程时间>40 d的患者发生骨坏死的机会较多,与无骨坏死患者比较有明显区别,P<0.005 和P< 0. 025; SARS 患者发病期血脂普遍增高,比较骨坏死和无骨坏死患者无差异。结论　SARS感染后骨坏死与甲泼尼龙治疗全程总剂量和治疗时间有关,临床病情与血脂增高对骨坏死的发生无统计学支持。OBJECTIVE To investigate the possible related factors of osteonecrosis in SARS patients, to improve the level of diagnosis and treatment of SARS, and to prevent osteonecrosis from SARS patients. METHODS Following 80 SARS patients discharged from hospital in 6 months, to measure serum biochemistry, observe clinical signs and symptoms in different stages and the daily and total dosage, duration of steroid therapy, and do statistical analysis of relative factors of osteonecrosis. RESULTS There were 26.3% cases who had osteonecrosis in followed 80 patients, most of them were medical workers, there was relationship with glucocorticoid (methylprednisolone) therapy. The patients with total treatment dosage over 6 000 mg and duration over 40 days had higher rate to suffering osteonecrosis, it had statistic difference (P<0.005, P<0.025, respectively). The SARS patient had hyperlipidemia, but it had no statistic difference between the patients with or without osteonecrosis. CONCLUSIONS Total treatment dosage and time of methylprednisolone therapy are possible related factors of osteonecrosis, no obvious relationship with hyperlipidemia, and the severity of disease.

关 键 词：严重急性呼吸综合征 骨坏死 激素 治疗 

分 类 号：R183.3[医药卫生—流行病学]