Chest X Ray Changes After Discontinuation of Glucocorticosteroids Treatment on Severe Acute Respiratory Syndrome (5 cases report)

摘要

Objective To investigate the effect of glucocorticosteroids on severe acute respiratory syndrome (SARS) and chest X ray changes after discontinuation of glucocorticosteroids treatment. Methods To retrospectively study the clinical characteristics of 5 cases with SARS and chest X ray changes after discontinuation of glucocorticosteroids. Results 5 cases were medical workers and had exposure to SARS patients. The incubation periods were 2 to 7 days. They had high fever from the onset of the disease. There were lung infiltrates 1 to 6 days after fever and then methylprednisolpne was given to them. Two or three days after glucocorticosteroids treatment, clinical symptoms in these patients were disappeared . The clinical symptoms in case 1, case 2, case 4 and case 5 weren't deteriorated after discontinuation of methylprednisolone while the presentation in chest X ray was progressed 3-6 days later. No more methylprednisolone was given to the patients and the infiltrates in chest X ray was gradually absorbed in 5-11 days. The temperature in case 3 was elevated again and the shadow in chest X ray was progressed after discontinuation of methylprednisolone due to the low dosage of glucocorticosteroids. When the dosage of methylprednisolone was increased, the temperature tended to be normal and the lung infiltrates began to absorb gradually. Conclusion For the patients with non - severe SARS, if the symptoms were disappeared after discontinuation of glucocorticosteroids, the lung shadow may be progressed. we can closely observe the condition of the disease and no more glucocortisteroids needed to be given to the patients. The lung shadow could be absorbed gradually.