在COVID-19相关的扩散间歇性肺异常中,12周的皮质类固醇治疗的结果
B H Ng1, M I Azmi2, N N N Abeed1
1Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Faculty of Medicine, Department of Medicine, Respiratory Unit, Kuala Lumpur, Malaysia.
The Medical journal of Malaysia
|May 31, 2024
概括
12周的普雷迪尼索隆显著改善了肺部成像,并减少了COVID-19相关肺部异常患者的呼吸困难. 这种皮质类固醇疗法在治疗COVID-19后的扩散性间歇性肺异常方面显示出安全性和有效性.
科学领域:
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
- 放射学 放射学是一门学科.
背景情况:
- COVID-19可能导致持续的肺部异常,特别是扩散间歇性肺部异常 (DILA).
- 与COVID-19相关的DILA的长期皮质类固醇治疗的有效性需要进一步调查.
- 计算机断层扫描 (CT) 肺部严重性得分对于评估DILA进展和治疗反应至关重要.
研究的目的:
- 评估12周口服普雷迪尼索隆疗程对中度至重度COVID-19相关DILA患者的益处.
- 通过分析CT肺部严重性得分的变化来评估治疗疗效.
- 为了确定DILA的皮质类固醇治疗对呼吸障碍的安全性和影响.
主要方法:
- 对330名中度至重度COVID-19肺炎的成年患者进行了回顾性,单中心的观察性研究.
- 患者在2021年1月至2021年12月期间接受了12周的口服普雷迪尼索隆.
- 收集的数据包括临床参数,CT肺部严重性得分,修改的医学研究委员会 (mMRC) 呼吸障碍尺度和肺功能测试.
主要成果:
- CT肺部严重性得分从平均17.3 (SD 5.3) 到8.6 (SD 5.5) (p<0.001) 显著改善.
- 在98.8%的患者中观察到放射性反应,地面玻璃不透明度和巩固的改善.
- 最小的残留性呼吸障碍,mMRC中位数为1 (IQR 0-1). 常见的副作用包括体重增加 (13.9%) 和高血糖 (1.8%).
结论:
- 12周的普雷尼索隆疗法有效改善了CT评估的肺部异常,并在COVID-19相关的DILA中减少呼吸障碍.
- 治疗被发现是相对安全的,显著副作用的发病率很低.
- 较长的皮质类固醇持续时间可能为COVID-19相关的中度至严重的DILA患者提供进一步的益处.
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