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目的 研究短期应用甲基强的松龙 (mythylprednisolone)治疗传染性非典型肺炎(SARS)对患者空腹血糖和电解质水平的影响。 方法 采用病例回顾性分析的方法 ,对比分析了10 3例SARS患者中 3 9例使用甲基强的松龙在治疗第 1周和停药后 1周空腹血糖和电解质水平的变化。 结果 甲基强的松龙的平均日用量为 (113± 44)mg ,疗程 (12± 4)d ,总剂量达 (13 4 7± 773 )mg时 ,可引起下列变化 :(1)激素治疗 1周时患者空腹血糖比对照组升高约 2 5.5% [(6.4± 2 .5)mmol/L与 (5.1± 1.1)mmol/L ,P <0 .0 0 1]。停用 1周时复查空腹血糖 ,治疗组和对照组间差异无显著意义 [(4 9± 1 8)mmol/L与 (4.9± 0 .9)mmol/L ,P >0 .0 5]。 (2 )激素治疗组中空腹血糖≥ 7.0mmol/L的患者比例显著高于对照组 [(3 9.5%与 11.9% ) (P <0 .0 5) ] ,正常血糖患者的比例明显低于对照组 ,为 55.3 %与 85.5% (P =0 .0 1)。 (3 )停用甲基强的松龙后 ,血钠和氯低于对照组 (P <0 0 5) ,但仍在正常范围以内。 结论 (1)甲基强的松龙治疗的第 1周可以观察到空腹血糖水平上升达2 5.5%。在停药后 1周基本可以恢复到正常水平。 (2 )短期应用糖皮质激素对血清钾、钠和氯的水平无不良影响
Objective To investigate the effect of short-term administration of mythylprednisolone on the fasting blood glucose and electrolytes in patients with SARS. Methods A retrospective analysis was conducted to compare the changes of fasting blood glucose and electrolytes in 39 cases of 103 SARS patients treated with methylprednisolone for 1 week and 1 week after treatment. Results The average daily dosage of methylprednisolone was (113 ± 44) mg. After the course of treatment (12 ± 4) days and total dose of (1347 ± 773) mg, the following changes could be caused: (1) Fasting blood glucose was increased by about 5.5% [(6.4 ± 2.5) mmol / L vs (5.1 ± 1.1) mmol / L, P <0.01] at 1 week. There was no significant difference between the treatment group and the control group (P <0.05). (4 9 ± 1 8) mmol / L and (4.9 ± 0.9) mmol / L, P 0 05]. (2) The proportion of patients with fasting blood glucose≥7.0mmol / L in hormone therapy group was significantly higher than that in control group (9.5% vs11.9%, P0.05) (P0.05), and the proportion of patients with normal blood glucose was significantly lower than that in control group Group, 55.3% and 85.5% (P = .0 1). (3) After the withdrawal of methylprednisolone, the serum sodium and chloride were lower than the control group (P <0 05), but still within the normal range. Conclusion (1) During the first week of methylprednisolone treatment, the fasting blood glucose level increased by 25.5%. 1 week after withdrawal can be restored to normal levels. (2) Short-term use of glucocorticoids has no adverse effect on serum potassium, sodium and chloride levels