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目的 探讨导致严重急性呼吸综合征(SARS)感染后骨坏死相关因素,提高SARS诊断、治疗水平,预防骨坏死发生。方法 对住院临床诊断SARS的80例患者出院后跟踪6 个月随访;检测血液生化,观察不同时期症状,总结SARS感染后骨坏死发生与激素治疗每天最大剂量、疗程、治疗全程总量和临床相关因素。结果 SARS感染后骨坏死跟踪样本发生率26.3%,以医务人员居多;糖皮质激素(甲泼尼龙)对骨坏死的形成有辅助作用,甲泼尼龙治疗全程总剂量>6 000 mg和治疗疗程时间>40 d的患者发生骨坏死的机会较多,与无骨坏死患者比较有明显区别,P<0.005 和P< 0. 025; SARS 患者发病期血脂普遍增高,比较骨坏死和无骨坏死患者无差异。结论 SARS感染后骨坏死与甲泼尼龙治疗全程总剂量和治疗时间有关,临床病情与血脂增高对骨坏死的发生无统计学支持。
Objective To investigate the related factors of osteonecrosis after severe acute respiratory syndrome (SARS) infection and to improve the diagnosis and treatment of SARS and prevent the occurrence of osteonecrosis. Methods Eighty patients with clinically diagnosed SARS in hospital were followed up for 6 months after follow-up. Blood biochemistry was observed and symptoms at different stages were observed. The maximum dose, duration of treatment, total amount of treatment and clinical correlation between the incidence of osteonecrosis and hormonal treatment after SARS infection were summarized factor. Results The incidence of osteonecrosis follow-up after SARS infection was 26.3%, mostly medical workers; glucocorticoid (methylprednisolone) had an auxiliary role in the formation of osteonecrosis; the total dose of methylprednisolone> 6 000 mg and the duration of treatment The patients with> 40 days had more chances of osteonecrosis, which were significantly different from those without osteonecrosis (P <0.005 and P <0. 025). The blood lipids were generally higher in the patients with SARS, difference. Conclusion The incidence of osteonecrosis after SARS infection is related to the total dose and duration of treatment with methylprednisolone. There is no statistical difference between the clinical manifestations and the elevated serum lipids in the incidence of osteonecrosis.