甲基普雷迪尼索隆与德克萨米他作为中度COVID-19肺炎的初始抗炎疗法之间的比较研究:一个开放的随机对照试验
Jakkrit Laikitmongkhon1, Tanapat Tassaneyasin2, Yuda Sutherasan3
1Division of Pulmonary and Pulmonary Critical Care Medicine, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand.
高剂量的甲基普雷迪尼索隆在适度的COVID-19肺炎中没有比德克萨米他更好的结果. 这两种治疗都导致了类似的世卫组织临床进展量表,死亡率和住院时间.
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
- 肺部病理学 肺部病理学
背景情况:
- 适度的COVID-19肺炎的最佳抗炎疗法尚未确立.
- 这项研究比较了住院患者中高剂量甲基prednisolone和dexamethasone.
研究的目的:
- 为了比较甲基普雷迪尼索隆与德克萨米他在中度COVID-19肺炎中的有效性.
- 评估的结果包括世卫组织的临床进展尺度,死亡率和住院时间.
主要方法:
- 开放式随机对照试验,涉及中度COVID-19肺炎患者.
- 患者接受甲基prednisolone (250毫克/天) 或德克萨梅他 (20毫克/天) 三天,然后逐渐减小剂量方案.
- 主要结局是世卫组织5日临床进展量表;次要结局包括90天死亡率和ICU转移.
主要成果:
- 在第5天和第10天的WHO临床进展量表中,甲基prednisolone和dexamethasone组之间没有显著差异.
- 住院死亡率,住院时间和ICU转移率在两种治疗手臂之间相似.
- 在长达90天的时间内,在类固醇相关并发症中没有发现显著差异.
结论:
- 初始高剂量甲基普雷迪尼索隆 (250毫克/天3天) 与高剂量德克萨相比,在中度COVID-19肺炎中没有提供优越的结果.
- 这两种治疗方法在这个患者队列中表现出可比的疗效和安全性.
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