从严重急性呼吸综合征到2019冠状病毒病:探讨激素性股骨头坏死的防治

From SARS to COVID-19:Discussion on the prevention and treatment of steroid-induced femoral head necrosis

2019年出现了一种全球流行的新型冠状病毒,这是继2003年严重急性呼吸综合征(severe acute respiratory syndrome,SARS)、2012年中东呼吸综合征(Middle East Respiratory Syndrome,MERS)之后,另一种可以在人体间传播的2019冠状病毒病(coronavirus disease 2019,COVID-19)。在治疗COVID-19和SARS时,都会不可避免地使用激素治疗以控制患者的病情。10多年间,SARS患者激素治疗后出现了股骨头坏死(osteonecrosis of the femoral head,ONFH),且诸多研究通过系统性随访证明了这种关联。多年的研究表明药物治疗、物理治疗及保髋手术治疗在激素性ONFH的防治中具有一定的积极作用。COVID-19治愈患者应定期到医院复查,医生应根据复查结果,将患者划分为ONFH高低风险人群,并根据病情做相应预防。

Since 2019,a new type of coronavirus has spread globally.This is a novel coronavirus disease 2019 that can spread from human to human after SARS in 2003 and MERS in 2012.To deal with a high-dose steroid is frequently used to improve the respiratory condition of patients with severe pneumonia.During 10 years follow-up of these patients,however,quite a number of them presented with osteonecrosis of the femoral head(ONFH),and several studies has proved the strong correlation between ONFH and steroid therapy.After years of reseach,it has been shown that these treatments based on drugs,physical therapy,and hip-preserving surgery have certain positive effects on preventing and treating steroid-induced ONFH.Therefore,the patients who suffered from COVID-19 and experienced steroid therapy should come to hospital for periodic review after they were recovered from COVID-19,and they should be divided into high-and low-risk groups for ONFH,and taken customized preventive measures.