The role and the best time of the glucocorticoid(methyprednisolone) on severe acute respiratory syndrome(SARS) were observed. All patients included 32 SARS patients treated with methyprednisolone and 10 slight SARS patients untreated with methyprednisolone were studied. The counts of CD4+, CD8+ and CD3+, temperature, blood routine, and chest X-ray before and after the treatment were analyzed, and after 1 week the changes of chest X-ray sheet of slight SARS patients which were treated with methyprednisolone or not, were observed. The results show: the counts of CD4+, CD8+ and CD3+ were (482 +/- 186), (390 +/- 213) and (804 +/- 272) muL(-1), and after treatment with methyprednisolone, they descended to (376 +/- 175), (283 +/- 234) and (529 +/- 383) muL(-1); the methyprednisolone has more therapeutic efficacies for serious SARS patients but has no obvious effect for light SARS patients. The glucocorticoid may reduce remarkable the immunological function of SARS patient, therefore, we must grasp the signs and occasion when we plan to use glucocorticoid for the SARS patients. The signs are as follows: 1) the lesion involves two lobes of the whole lung,and the coverage is more than 1/3; 2) the lesion of lung becomes bigger more than 50% during the 48 h; 3) when the ALI or ARDS happen. The second important thing is the dosage and course must be individualization. The signs of increase and decrease dose of glucocorticoid depend completely on the condition of SARS patients.
