460例SARS患者应用糖皮质激素致不良反应的探讨  

Investigation of adverse reactions to glucocorticoids in 460 SARS patients

作　　者：王育琴[1] 闻满华[1] 常明[2] 丁庆华[2] 曾艳[1] 孟莉[1] 吴晓光[1] 汤哲[1] 牛光胜[3] 

机构地区：[1]首都医科大学宣武医院,北京100053 [2]中日友好医院,北京100029 [3]北京安定医院,北京100088

出　　处：《药物不良反应杂志》2004年第2期78-82,共5页Adverse Drug Reactions Journal

摘　　要：目的:本文旨在探讨SARS患者应用糖皮质激素的不良反应及其相关影响因素。方法:对首都医科大学宣武医院和中日友好医院收治的460例SARS患者进行详细的病史询问及体检,检查血常规、血生化,并详细记录全部临床资料及转归。患者各项资料使用SPSS11.0统计软件包进行统计并进行回顾性对照分析。结果:①460例患者中有344例(74.8%)使用了糖皮质激素,其中血钾降低为17.2%,血钙降低为32.0%,血糖升高为30.5%,精神障碍20.1%,细菌感染53.5%,真菌感染14.8%,肝功能损害60.2%,不良反应发生率明显高于未用激素组。②激素最大剂量≥320mg·d-1组不良反应明显高于<320mg·d-1组。结论:SARS患者使用糖皮质激素须严格掌握适应症;严密观察药物不良反应;使用大剂量宜慎重,在保证疗效的前提下,须尽可能减少剂量,切忌盲目增加剂量。一旦发生药物不良反应要积极采取补救措施。Objective : To investigate adverse reactions in SARS patients treated with glucocorticoids. Method:Clinical data of460cases with SARS in Xuanwu Hospital and China-Japa n Friendship Hospital were retrospectively analysed using SPSS statistical softw are.Results:344of460cases were under glucocorticoids therapy(GT),resu lting in decreased serum potassium(17.2%)and serum calcium(32.0%) ,increased blood sugar(30.5%),psychogeny(20.1%),bacterial infec tion(53.5%),mycotic infection(14.8%),and liver impairment (60 .2%).The incidence of adverse reactions were much higher in GT group of≥3 20mg daily than group of<320mg daily,and in GT group than in non-GT gr oup.Conclusion:Glucocorti-coids should only be used with great caution in SAR S patients,that is,paying more attention to existing indications and fol-lowi ng adverse effects,taking the drug doses as low as possible,and high doses may be only used for life-threatening case.

关 键 词：严重急性呼吸综合征 糖皮质激素 不良反应 炎症反应 肺纤维化 

分 类 号：R511.9[医药卫生—内科学]