SARS患者康复期股骨头缺血性坏死病例对照研究

Case control study of avascular necrosis of femoral head during SARS patients＇ convalescence

目的探讨严重急性呼吸综合征（SAPS）患者康复期股骨头缺血性坏死的影响因素，为临床进一步研究SARS患者股骨头缺血性坏死的致病机制提供线索。方法调查92例SAPS康复患者治疗期间激素用法，随访康复患者1年以上，以MRI检测双侧髋关节，测定股骨头缺血性坏死。统计学分析采用Logistic回归多因素分析。结果92例SARS康复患者激素总量平均为（1479．9±188．3）mg，应用天数平均为（11．4±1．0）d，激素单日最大用量平均为（123．1±13．7）mg／d；有冲击疗法的患者6例，无冲击疗法的患者86例，其中有6例股骨头缺血性坏死；经统计学分析发现激素总量与股骨头缺血性坏死有统计学意义；年龄、性别、激素应用天数、有无冲击疗法、激素单日最大用量等因素与股骨头缺血性坏死无统计学意义。结论SAPS患者康复期股骨头缺血性坏死主要与治疗期间激素总量有关；与患者年龄、性别、激素应用天数、有无冲击疗法、激素单日最大剂量无关。

Objective To explore the influential factors of the avascular necrosis of femoral head during severe acute respiratory syndrome （SARS） patients＇ convalescence so as to supply the clues for the pathogenic mechanism. Method Investigated and recorded the usage of glueocortieoid to the convalescent SARS patients during therapy. After 1 year of follow - up, some patients suffering from avascular necrosis of femoral head were confirmed by examining their hip joints with MRI, and used the linear stepwise Logistic to analyse the cases. Results The total dose of glueoeortieoid was （ 1479.9 ± 188.3 ） mg, time was （ 11.4 ± 1. 0） d, the maximum dose in single day was （ 123.1 ± 13.7 ） mg/d, pulse therapy were 6 eases, no pulse therapy were 86 eases. The factors of femoral head necrosis included dose of glueoeorticoid. There were no relations between age, sex, time, pulse therapy, the maximum dose in single day and femoral head necrosis. Conclusion The oceurenee of avaseular necrosis of femoral head is well related with the total dose of glucocorticoid, not with age, sex, time, pulse therapy and the maximum dose in single day.