SARS患者激素治疗与继发感染关系的探讨

Discussion on the relation between glucocorticoid therapy and secondary infection of SARS Patients

目的:探讨传染性非典型肺炎(SARS)患者使用糖皮质激素治疗与继发感染的关系。方法:对我院2003年3月26日至5月24日住院治疗的253例非典型肺炎患者的血、尿、便、痰等标本进行细菌培养,对培养结果依据糖皮质激素使用情况分类进行统计分析。结果:253例患者标本中共分离出致病菌80株。79例未使用激素者,继发感染率7.6%;174例使用糖皮质激素治疗者,继发感染率为19.0%。其中普通型SARS的继发感染率为12.9%,重症SARS的继发感染率25.9%,使用糖皮质激素小剂量患者的感染率为10.3%,中大剂量患者的感染率为23.3%。结论:SARS患者使用糖皮质激素治疗出现的继发感染率要高于未使用激素者,随着糖皮质激素使用剂量的增加,患者继发感染的几率也在增加;重症患者使用糖皮质激素后更易引起继发感染。因此,在治疗SARS病人中应注意合理使用激素。

Objective:To discuss the relation between glucocorticoid therapy and secondary infection(SI )of SARS patients.Method:Bacterial cultures of blood,urine,stool and sputum of the SARS patients were made in our hospital from26March to24May2003,with statistic analysis of the cases treated with glucocorticoid.Results:There were80individual strains of bacteria isolated from253cases.174patients of them were treated with glucocorticoid.The SI rate was19.0%,while the SI rate of79patients without steroids treatment was7.6%.Statistics showed the significant difference between the two (P<0.01).In severe SARS SI rate was25.9%,for the rest,12.9%.SI rate for patients under the low dose was10.3%and under the high dose,23.3%.Conclusion:The SI rate in SARS patients with glucocorticoid treatment was higher than the rate without it.The severe paitents were much easier infected after steroids because of their suppressed immunity.So the glucocorticoid should be used carefully.