糖皮质激素对人腺病毒55型感染治疗转归的影响  

Effects of glucocorticoids on the outcome of treatment of human adenovirus type 55 infection

作　　者：梁建琴[1] 雷红[2] 周瑾[3] 吴佳佳[3] 李川 陈志[1] 王金河[1] 武丽红 刘景阳 白春凤 张陶然 刘倩颖[1] 李燕峰[1] Liang Jianqin;Lei Hong;Zhou Jin;Wu Jiajia;Li Chuan;Chen Zhi;Wang Jinhe;Wu Lihong;Liu Jingyang;Bai Chunfeng;Zhang Taoran;Liu Qianying;Li Yanfeng(Department of Tuberculosis,Tuberculosis Reserch Insititute,the 8th Medical Center of Chinese PLA General Hospital,Beijing 100091,China;Department of Clinical Laboratory,the 8th Medical Center of Chinese PLA General Hospital,Beijing 100091,China;Department of Medical,the 8th Medical Center of Chinese PLA General Hospital,Beijing 100091,China;Department of Emergency,the 8th Medical Center of Chinese PLA General Hospital,Beijing 100091,China)

机构地区：[1]解放军总医院第八医学中心全军结核病研究所结核科,北京100091 [2]解放军总医院第八医学中心检验科,北京100091 [3]解放军总医院第八医学中心卫勤部,北京100091 [4]解放军总医院第八医学中心急诊科,北京100091

出　　处：《中国医刊》2020年第11期1189-1192,共4页Chinese Journal of Medicine

摘　　要：目的探讨糖皮质激素对人腺病毒55型感染治疗转归的影响。方法收集解放军总医院第八医学中心2020年2月3—4日收治的32例人腺病毒55型感染住院患者的临床症状、体征、实验室检查、胸部CT表现等临床资料,根据患者肺部病变范围和日最高体温制定甲泼尼龙分类治疗方案。比较治疗前后患者的临床症状、实验室检查及胸部CT表现。结果32例患者均为青年男性,平均年龄(21.3±2.1)岁;甲泼尼龙使用时间3~10d,平均(6.7±2.3)d,最大使用剂量为80mg(2次/d);治疗6d,32例患者体温均恢复正常。治疗7d,血常规、红细胞沉降率、C反应蛋白和谷丙转氨酶较入院时明显好转(P<0.05)。出院时22例肺部CT病变范围缩小均≥1/2,显效率为100%,其中15例病变全部吸收,治愈率为68.2%。病毒清除时间约为2周。不良反应发生率为6.25%。结论在抗病毒、对症治疗的基础上,早期小剂量短疗程应用糖皮质激素治疗人腺病毒55型感染,疗效明显,不良反应少。Objective To investigate the effect of glucocorticoids on treatment outcome of human adenovirus type 55 infection.Method The clinical symptoms,signs,laboratory data and chest CT of 32 hospitalized patients with human adenovirus serotype 55 infection were collected.And the methylprednisolone classified treatment plans were developed according to the range of lung lesions and the daily maximum body temperature.The clinical symptoms,examination indexes and chest CT of before and after treatment were compared.Result All the 32 patients were young males with an average age of(21.3±2.1)years.The methylprednisolone was used for 3 to 10 days,with an average of(6.7±2.3)days and a maximum dose of 80mg bid.At the 6th day of treatment,all 32 patients had fever reduction.The indexes of blood routine,blood sedimentation,CRP and glutamate were significantly better than those at the time of admission(P<0.05).In comparison with the lung CT on admission to hospital,the scope of lung lesions in 22 cases was reduced by≥1/2,and the apparent efficiency was 100%,among which 15 cases were all absorbed,and the cure rate was 68.2%.Adenovirus clearance time is about 2 weeks.The incidence of adverse reactions was only 6.25%.Conclusion On the basis of antiviral and symptomatic treatment,early small dose and short course of glucocorticoid were used to treat human adenovirus type 55 infection with less adverse reactions and obvious efficacy.

关 键 词：人腺病毒55型 感染 肺炎 甲泼尼龙 治疗 

分 类 号：R563.1[医药卫生—呼吸系统]