德克萨米他与甲基普雷迪尼索隆用于COVID-19重症患者的多器官功能障碍:多中心倾向性得分匹配研究
Ohoud Aljuhani1, Ghazwa B Korayem2, Ali F Altebainawi3,4
1Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia.
与甲基prednisolone相比,德克萨米在严重的COVID-19患者中显示出较低的多器官功能障碍评分 (MODS). 在皮质类固醇治疗之间,死亡率相似.
科学领域:
- 临界护理医学 临界护理医学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 像甲这样的皮质类固醇是严重的COVID-19的标准,以减少死亡率.
- 甲基普雷迪尼索隆与德克萨米他在COVID-19中的比较疗效尚不清楚.
- 本研究评估了德克萨米他与甲基prednisolone相比的临床和安全结果.
研究的目的:
- 在严重的COVID-19患者中,比较德克萨米他与甲基普雷迪尼索隆的临床结果.
- 评估与每个皮质类固醇相关的安全概况和死亡率.
- 为了确定甲基普雷迪尼索隆在COVID-19治疗中是否比德克萨米他具有优势.
主要方法:
- 一个多中心的,回顾性队列研究包括成人COVID-19患者入住了ICU.
- 患者在ICU入院后24小时内接受了德克萨米他或甲基普雷迪尼索隆.
- 倾向性得分匹配 (1:3比) 用于控制混因素;主要结局是第三天的MODS.
主要成果:
- 在PS匹配后,分析了264名患者 (198名德克萨米他,66名甲基前尼索隆).
- 甲基prednisolone组在第三天显示出更高的MODS (β:0.17,P=0.03) 和增加的医院获得的感染 (OR 2.17,P=0.04).
- 两组之间30天或住院死亡率没有观察到统计学上显著的差异.
结论:
- 在严重的COVID-19中,甲导致第三天的MODS较低,相比于甲基prednisolone.
- 两种皮质类固醇都没有显示出患者死亡率的统计学上显著差异.
- 德克萨米他可能更好地用于在严重的COVID-19中管理器官功能障碍.
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