论文部分内容阅读
目的探讨大剂量甲基泼尼松龙是否长期影响严重急性呼吸综合征(SARS)患者肾上腺皮质功能。方法分别对2003年4月至6月天津武警医学院附属医院收治的37例SARS康复患者发病后9、12个月,使用放射免疫的方法随访检测SARS康复患者血浆中促肾上腺皮质激素(ACTH)及血清中皮质醇(Cr)的质量浓度变化,并与25名正常人比较,观察与发病期间激素总量的关系。结果发病9个月时ACTH质量浓度明显低于发病12个月及正常对照组(P<0.05),Cr质量浓度明显高于12个月及正常对照组(P<0.05);9个月时甲基泼尼松龙剂量<4000mg组、4000～8000mg组及>8000mg组3种剂量对ACTH与Cr影响无差异;发病12个月时<4000mg组ACTH、Cr质量浓度与正常对照组差异无显著性,>8000mg组ACTH质量浓度与正常对照组无明显差异,Cr质量浓度低于正常对照组(P<0.05),>8000mg组ACTH高于正常对照组(P<0.05),Cr质量浓度低于正常对照组(P<0.05)。结论甲基泼尼松龙可导致长期肾上腺皮质功能抑制,与使用剂量有关。
Objective To investigate whether high-dose methylprednisolone may affect adrenocortical function in patients with severe acute respiratory syndrome (SARS) over the long term. Methods 37 cases of SARS rehabilitation patients admitted to the Affiliated Hospital of Tianjin Armed Police Medical College from April to June 2003 were followed up for 9 and 12 months respectively. The levels of adrenocorticotropic hormone (ACTH) in plasma of patients with SARS were detected by radioimmunoassay. And serum cortisol (Cr) concentrations, and compared with 25 normal subjects to observe the relationship with the total amount of hormones during the onset. Results The concentration of ACTH at 9 months after onset was significantly lower than that at 12 months and normal control (P <0.05), and the Cr concentration was significantly higher than that at 12 months and normal control (P <0.05). At 9 months, There were no significant differences in the ACTH and Cr levels between the doses of <4000mg, 4000 ~ 8000mg and> 8000mg for the doses of geniposyton, but there was no significant difference between ACTH and Cr concentrations in the <4000 mg group (P <0.05). The levels of ACTH in> 8000mg group were lower than those in normal control group (P <0.05) Control group (P <0.05). Conclusion Methylprednisolone can cause long-term inhibition of adrenocortical function, with the dose.