SARS患者使用糖皮质激素的不良反应及其相关影响因素研究

为探讨严重急性呼吸综合征(SARS)患者使用糖皮质激素的不良反应及其相关影响因素,对我院收治的220例SARS患者进行详细的病史询问及体检,检查血常规、血生化,并详细记录全部临床资料及转归。患者的各项资料使用SPSS11.0统计软件包进行统计并进行回顾性对照分析。结果1)220例患者中有170例(77.3%)使用了糖皮质激素。用激素组不良反应发生率明显高于未用激素组。其中血钾降低为17.6%,血钙降低为68.3%,血糖升高为30.6%,精神障碍为28.8%,真菌感染为20.7%。2)激素日最大剂量320mg以上组不良反应明显高于320mg以下组。激素疗程对不良反应发生率无明显影响。提示SARS患者使用糖皮质激素必须严密观察药物不良反应;使用剂量宜慎重,在保证疗效的前提下,尽可能减少剂量,切忌盲目增加剂量。

Adverse Drug Reaction of Gluco-corticosteroid and Associated Factors in SARS medication

The objective to study the adverse drug reaction(ADR)of gluco-corticosteroid and its associated factors in SARS(severe acute respiratory syndrome)medication.All SARS patients(totally220persons)were checked in history,body examination,routine blood test and blood biochemistry examination.All SARS cases in our hospital were analyzed retrospectively with statistic software SPSS11.0.Results:The incidence of ADR in170patients(77.3%)with gluco-corticoid administration was much higher than that in patients without glucocoticoid.The incidence of ADR in patients treated with glococorticoid more than320mg per day was also much higher than that in patients with glucocoticoid lower than320mg per day.A variety of ADR included decrease of potassium(17.6%)and calcium(68.3%)in the blood,increase of blood sugar(30.6%),psychiatric symptom(28.8%)and fungal infection(20.7%).ADR of SARS patients treated with glucocorticoid should be monitored strictly.To reduce the incidence of ADR in SARS patients,administration of glucocorticoid should be controlled strictly and carefully,especially the high dosage of drugs must be avoided.