摘要
目的了解糖皮质激素(简称激素)使用及严重急性呼吸综合征(SARS)感染本身对SARS康复者股骨骨髓转换的影响。方法观察148例SARS[42例未用激素(未用激素组)、106例使用激素(使用激素组)]康复医务人员及97名年龄与性别匹配的正常对照者(正常对照组)磁共振成像(MR I)上股骨近端骨髓的分布,并在T1加权成像上测量并比较未用激素组、使用激素组的SARS康复者及正常对照组之间骨髓转换指数的差异。结果148例中106例使用激素的SARS康复者,4例出现股骨头缺血坏死,2例股骨骨髓水肿,1例股骨颈骨梗死。正常对照组、未用激素组及使用激素组SARS康复者骨髓转换指数分别为(79.4±6.8)%、(86.9±7.4)%、(88.6±5.9)%,使用激素组与未用激素组、使用激素组与正常对照组、未用激素组与正常对照组的比较,P值分别为<0.05、<0.01、<0.01,差异均有统计学意义。结论激素的应用可促进股骨近端骨髓黄骨髓化,而SARS感染本身也可导致股骨颈红骨髓过度转换为黄骨髓。
Objective To determine the effect of corticosteroid treatment and severe acute respiratory syndrome（SARS） infection itself on the marrow conversion in the proximal femoral marrow in the recovered patients of health care workers with SARS. Methods The distribution of proximal femoral marrow on MR imaging of 148 health care workers with recovered SARS including 106 cases treated with varied dosage of steroids and 42 cases without steroid, and 97 age and sex matched health adults as controls were observed. The index of marrow conversion （ signal intensity of the femoral neck and intertrochanteric area divided by signal intensity of the greater trochanter multiplied by 100% ） was quantitatively measured and compared between SARS patients treated with steroid and without steroid and the normal control group. Results In 106 cases treated with steroid of the 148 health care workers, femoral head osteoneerosis was found in 4 cases,bilateral femoral marrow edema in 2 cases,femoral marrow infarction in 1 case. The index of marrow conversion in the normal controls, in SARS patients treated without and with steroids was （79. 4 ± 6. 8） %, （ 86. 9 ± 7.4 ） %, （ 88. 6 ± 5. 9 ） %, respectively. There was significantly statistical difference between groups（P 〈0. 05）. Condusion In addition to fat conversion in the proximal femoral marrow due to steroid treatment, the infection of SARS itself may promote an excessively conversion of the red marrow to yellow marrow of the femoral neck in SARS patients.
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2006年第3期189-193,共5页
Chinese Journal of Tuberculosis and Respiratory Diseases
基金
广东省传染性非典型肺炎(非典)科技攻关项目中西医结合治疗非典专题组组长经费资助(200321-E01114)
关键词
严重急性呼吸综合征
骨髓
磁共振成像
Severe acute respiratory syndrome
Bone marrow
Magnetic resonance imaging
