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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 summarize the clinical manifestations of SARS and the effect of glucocorticoid therapy on SARS (Severe Acute Respiratory Syndrome). Methods The clinical and radiographic findings of 126 patients with confirmed SARS who were admitted to our hospital from April to May in 2003 were analyzed and their changes before and after glucocorticoid were quantitatively analyzed. Results Of the 126 patients, 51 were males and 75 were females with an average age of (34 ± 12.7) years. The main symptoms include fever, cough, myalgia, fatigue, headache, expectoration, chest tightness, suffocation and diarrhea. After treatment with glucocorticoids, the temperature of the patient decreased rapidly and returned to normal gradually. The symptoms such as myalgia, headache and other symptoms were significantly reduced after treatment with glucocorticoid. The symptoms such as cough, expectoration and diarrhea started a few days after the onset of symptoms Reduce, continue to reduce symptoms after using glucocorticoids; chest tightness, suffocation symptoms in the first 5 days after glucocorticoid began to reduce and continue to improve. Chest radiographs of lung shadow from the first day after the use of glucocorticoids to reduce, to the fifth day difference was significant, continue to follow-up for 3 weeks, the shadow continued absorption. Conclusion The rational use of glucocorticoids can significantly reduce the lung disease and clinical symptoms of SARS and is an effective method in the treatment of acute SARS.