SARS患者激素治疗与预后关节痛的研究  

Analysis of relation between the usage of corticosteroid in treatment and arthralgia as a sequela of SARS patients

作　　者：高宏生[1] 王世鑫[2] 陈礼明[2] 李玉明[2] 苑淑玲[3] 焦振山[3] 惠武利[1] 杨震[2] 赵志勇[2] 

机构地区：[1]武警医学院流行病学教研室,天津300162 [2]武警医学院附属医院,天津300162 [3]天津市卫生局科教处,300162

出　　处：《中国危重病急救医学》2004年第5期277-280,共4页Chinese Critical Care Medicine

基　　金：天津市科委科技发展计划项目 (0 3 3 113 3 11)

摘　　要：目的　探讨严重急性呼吸综合征 (SARS)患者的激素用法与预后关节肿痛的关系。方法　通过分析对 SARS期间的病历资料和医嘱 ,回顾性调查 30例无基础疾病患者的一般情况和激素用法 (包括激素使用总量、持续时间、最高剂量、最高剂量使用持续时间、减药速度 ) ;患者出院 1个月后 ,统一组织调查 SARS患者预后关节痛的有关情况。统计分析采用多元逐步回归法。结果　 SARS患者治疗期间甲基泼尼松龙使用总量为 (42 4 4 .16± 2 2 92 .30 ) m g,使用总时间为 (2 5 .36± 5 .88) d,最高剂量为 (32 1.33± 174 .0 3) m g/ d,最大剂量使用持续时间 (7.73± 4 .0 8) d,减药速度为 (2 1.33± 10 .18) mg/ d。恢复期间出现关节痛 2 6例 ,占 86 .6 7% ;从发病之日到关节痛出现的时间 ,以 1个月以内组发病患者数最多 (为 9例 ) ,占 34.6 2 % ;晚上疼痛明显者仅占 7.6 9% (2例 ) ;轻度疼痛者最多 ,占 5 3.85 %。单因素分析显示 :关节痛程度与激素总量、用药持续时间、用药最大剂量、最大剂量持续时间、停药速度有相关关系 ;关节痛持续时间与激素总量、用药持续时间、用药最大剂量有相关关系 ;年龄与关节痛程度和持续时间都无相关关系。多因素分析显示 :关节痛程度仅与激素使用总量有关 。Objective To analyze relation between the use of corticosteroids in the treatment for severe acute respiratory syndrome(SARS) patients and arthralgia as a sequela. Methods Clinical date of 30 SARS patients without other diseases in whom corticosteroid was used were reviewed including total dosage ,duration of use,the highest dosage and its duration,and speed of reduction in dosage. The information about arthralgia were investigated one month after discharge of SARS patients from the hospital. Results The average total dosage of methylprednisolone was(4 244.16±2 292.30) mg,and the duration of use of the treatment was (25.36±5.88)days (ranging from 12 to 35 days). The maximum dosage was(321.33±174.03) mg/d,and the duration of its use was (7.73±4.08)days. The speed of reduction of dosage of corticosteroids was (21.33±10.18) mg/d. There were 26 of 30 patients(86.67%) experienced arthralgia symptom during convalescence. In 34.6% of patients arthralgia occurred within one month after SARS,53.85% of the patients experienced lowgrade arthralgia. By unifactor analysis,the total dosage and its duration of use,the highest dosage and its duration,speed of reduction of dosage of corticosteroids were correlated with the degree of arthralgia,respectively. The duration of arthralgia was correlated with the total dosage,the duration of high dosage,and high dosage. Age was not correlated with either the degree or the persisting time of arthralgia. The degree of arthralgia was only correlated with the total dosage,and the duration of arthralgia was correlated with administration time of glucocorticosteroids by multifactor analysis. Conclusion There is a dosageeffect relation between the degree of arthralgia and the total dosage of corticosteroid ,and a timeeffect relation between the duration of arthralgia and length of the use of corticosteroids.

关 键 词：严重急性呼吸综合征 激素 关节痛 预后 

分 类 号：R511.9[医药卫生—内科学]