社区获得性肺炎患者的辅助普得尼松疗法:一个多中心,双盲,随机,安慰剂控制的试验
Claudine Angela Blum1, Nicole Nigro2, Matthias Briel3
1Endocrinology, Diabetology and Metabolism, Department of Internal Medicine and Department of Clinical Research, University Hospital Basel, Basel, Switzerland; Medical University Clinic, Departments of Internal and Emergency Medicine and Department of Endocrinology, Diabetology and Clinical Nutrition, Kantonsspital Aarau, Aarau, Switzerland.
短期普得尼松治疗显著加快住院社区获得的肺炎患者的恢复. 这种皮质类固醇治疗可以缩短临床稳定的时间,而不会增加并发症,改善患者的治疗结果和医院的效率.
科学领域:
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
- 临床药理学 临床药理学
背景情况:
- 关于系统性皮质类固醇对社区获得性肺炎 (CAP) 的疗效,存在相互矛盾的临床试验数据.
- 评估短期皮质类固醇治疗对住院CAP患者康复时间的影响至关重要.
研究的目的:
- 为了确定短期皮质类固醇治疗是否加快了社区获得性肺炎住院患者临床稳定的时间.
主要方法:
- 这是一项双盲,多中心,随机,安慰剂对照试验,涉及785名患有CAP的成年患者.
- 患者接受了每天50毫克的普得尼松,持续7天,或安慰剂.
- 主要终点:通过治疗意图分析的临床稳定性 (定义为稳定的生命体征≥24小时) 的时间.
主要成果:
- 与安慰剂组 (4,4天) 相比,在普得尼松组 (3.0天) 中,临床稳定的中位时间明显较短.
- 在小组之间,直到30日,肺炎相关并发症没有显著差异.
- 在普得尼松组 (19%对11%) 中,需要胰岛素治疗的住院高血糖症的发病率更高.
结论:
- 住院社区获得的肺炎患者的七天普得尼松治疗缩短了临床稳定的时间.
- 这种治疗方法不会增加并发症,并为患者的康复和医院资源利用提供了好处.
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