Glucocorticoid in the Treatment of SARS

摘要

Objectives To discuss the influence of glucocorticoid (such as Methylprednisolone) on SARS. Methods To observe 30 SARS patients in our hospital since March to May 2003 periodically whose courses are all over 3 weeks. Making statistic analysis of the course and dosage of the glucocorti-coid, the count of CD4, CD8, CD3, the electrolyte, blood glucose, blood routine, and sera albumine before and after the treatment. Results There are 29 of the 30 SARS patients were treated by Methylprednisolone . The dosage of 27 patients was 80 - 160 mg/day, the largest dosage is 1 000 mg/day (before enter our hospital) . The WBC was increased after treatment ( P < 0.01) ; there seems no obvious influence on the Potassium, Sodium and Chlorine in the blood (P > 0.05) , but the blood glucose was increased obviously after using glucocorticoid ( P < 0.05) . And the glucocorticoid can also decrease the level of sera albumin ( P < 0.01) , large dosage of glucocorticoid may decrease the count of CD4, CD8, and CD3; 3 severe patients appeared double - infection after large dosage of glucocorticoid. Conclusions During the early stage of the course, the count of CD4, CD8, and CD3 of the SARS patients may reduce obviously which means that the immunity was suppressed. And large dosage of glucocorticoid may aggravate the suppression , make the body in an active metabolic state (such as the increase of blood glucose, the decrease of sera albumine) . It may aggravate the illness much more,and patients were liable to suffer from severe secondary infection. So the indication of how to use the glucocorticoid is very important, we must control it strictly and do not use it in large dosage.