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【目的】探讨严重急性呼吸综合征(SARS)的糖皮质激素治疗与胸片所见的关系。【方法】收集广州市458例SARS患者的一般临床资料及每次胸片资料。所有患者都临床确诊并经免疫学检查证实,临床资料及胸片资料同时较齐全才作为研究对象。根据应用激素与否将其分为两组。【结果】应用激素组257例,未用激素组201例。两组在首次见到肺内病变时间之差异无统计学意义(t=1.417,P=0.157);激素用于临床表现较严重的病例,胸片上肺内病变达高峰时间较未用激素组长(t=3.242,P=0.001),所累及的肺小区个数较多(t=3.982,P<0.001),住院时间较长(F=2.731,P<0.001)。始用激素于病程10d之内及10d之后比较,后者肺内病变达高峰时所累及的肺小区个数较多。最大日剂量较大者,其病变存留较久、住院时间较多(F=3.040,7.044;P<0.001,<0.001)。【结论】激素用于症状较重的SARS患者的情况下,病死率不高,提示激素在SARS治疗中有重要意义。
【Objective】 To investigate the relationship between glucocorticoid therapy and chest radiograph in patients with severe acute respiratory syndrome (SARS). 【Methods】 The clinical data of 458 cases of SARS in Guangzhou and the data of each chest radiography were collected. All patients were clinically diagnosed and confirmed by immunological examination, clinical data and chest radiograph at the same time more complete before as a research object. According to the application of hormones will be divided into two groups. 【Results】 There were 257 cases of hormone group and 201 cases of no hormone group. There was no significant difference between the two groups in the first time to see the time of intrapulmonary lesions (t = 1.417, P = 0.157); hormones were used in cases with more severe clinical manifestations, (t = 3.242, P = 0.001). The number of lung cells involved was higher (t = 3.982, P <0.001) and hospital stay was longer (F = 2.731, P <0.001). The first use of hormones in the course of 10d and 10d after the comparison, the latter reached the peak lung lesions involving the number of lung cells more. Largest daily dose, the lesion persisted longer hospital stay (F = 3.040,7.044; P <0.001, <0.001). 【Conclusions】 The case fatality rate is not high in cases of severe symptoms of SARS with hormones, suggesting that hormones are of great significance in the treatment of SARS.