126例SARS临床表现及糖皮质激素治疗效果分析

Manifestations of 126 cases of diagnosed SARS and therapeutic effects of corticosteroids

目的总结传染性非典型肺炎(严重急性呼吸综合征,SeverAcuteRespiratorySyndrome,SARS)的临床表现及糖皮质激素治疗的效果。方法总结本院在2003年4月至5月间收治的126例确诊SARS病人的临床和X线表现,定量分析其在使用糖皮质激素前后的变化。结果126例患者中男性51人,女性75人,平均年龄(34±12.7)岁。主要症状包括高热、咳嗽、肌痛、乏力、头痛、咳痰、胸闷憋气及腹泻等。使用糖皮质激素治疗后,患者体温迅速明显下降并逐渐恢复正常;肌痛、头痛等症状在使用糖皮质激素后平均症状评分均明显减轻;咳嗽、咳痰及腹泻等症状在发病几天后开始减轻,使用糖皮质激素后症状继续减轻;胸闷憋气症状在使用糖皮质激素后第5天开始减轻并持续好转。胸片肺部阴影从使用糖皮质激素后第1天开始减轻,至第5天差异存在显著性,继续随访3周,阴影持续吸收。结论合理使用糖皮质激素可以明显减轻SARS的肺部病变及临床症状,是SARS急性期治疗中一种有效的方法。

Objective To determine the clinical manifestations of Severe Acute Respiratory Syndrome (SARS) and the effects of corticosteroids on the treatment of SARS. Methods 126 cases of diagnosed SARS patients were enrolled in Peking University First Hospital during April and May. in 2003. The manifestations and chest X-rays, as well as their changes before and after the corticosteroids therapy were quantitatively analyzed. Results Among the 126 cases, fever above 38℃, cough, myalgia, inertia, headache, expectoration, dyspnea and diarrhea were the most common symptoms. After using corticosteroids, body temperature quickly returned to normal; myalgia and headache were significantly relieved. Cough, expectoration and diarrhea relieved shortly after the onset of SARS and continued to relieve with the steroid therapy. Dyspnea began to relieve 5 days after the beginning of the therapy, coincided with the changes in chest X-rays. The shadows on chest X-rays began to be absorbed on the first day of steroids administration, and continuously absorbed in 3 weeks of follow-up. Conclusion Appropriate use of corticosteroids is effective in the treatment of SARS.