目的 探讨老年新型冠状病毒感染后反复发热的临床特点和治疗方法.方法 收集4例老年新型冠状病毒感染后反复发热的病例资料,分析其临床特点和糖皮质激素治疗的疗效.结果 患者男3例,女1例,年龄82～86岁,发热时间24～37 d,其中3例肺部病变轻,1例肺部病变重.在4例患者中,2例用小剂量糖皮质激素(甲泼尼龙片初始剂量20 mg·d-1),2例初始剂量较大(甲泼尼龙40 mg·d-1),退热时间2～4 d.肺部病变轻的3例患者应用激素疗程短,为3～6周;肺部病变重的1例应用激素疗程长,为23周.结论 对老年新型冠状病毒感染后反复发热的病例,如肺部病变轻微,可试用小剂量糖皮质激素短疗程治疗;如肺部病变重,可适当增大剂量,延长疗程.
Objective To investigate the clinical characteristics and therapeutic method in the eldly patients with recurrent fever after coronavirus disease 2019(COVID-19)infection.Methods The data of 4 eldly patients with recurrent fever after COVID-19 infection was collected and their clinical characteristics and efficacy of glucocorticoid therapy were analyzed.Results Three patients were male and 1 was female,their ages were 82-86 years old,fever time was 24-37 days.Lung lesions in 3 patients were mild and 1 was severe.Low dose glucocorticoid was used in 2 cases(the initial dose of methylprednisolone tablets was 20 mg daily).The higher initial dose was used in 2 other cases(methylprednisolone,40 mg daily).The duration of fever reduction was 2-4 days.The treatment course of glucocorticoid was as short as 3-6 weeks for the 3 patients with mild lung lesions,and as long as 23 weeks for the patient with severe lung lesion.Conclusion For eldly patients with recurrent fever after COVID-19 infection,if the lung lesion was mild,a small dose of glucocorticoid and a short course of treatment may be used;if the lung lesion was severe,the dose can be increased appropriately and the course of treatment prolonged.
邓美玉;于旭红;张令晖;陈玲
中国人民解放军第三○五医院呼吸内科,北京 100017中国人民解放军第三○五医院药局,北京 100017
药学
糖皮质激素治疗;新型冠状病毒感染;反复发热;老年患者
glucocorticoid therapy;coronavirus disease 2019 infection;recurrent fever;eldly patient
《中国临床药理学杂志》 2024 (001)
121-125 / 5
10.13699/j.cnki.1001-6821.2024.01.025
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