在医院获得的和与呼吸机相关的肺炎中使用葡萄糖皮质剂治疗
Cecile Poulain1, Marwan Bouras2, Antoine Roquilly1
1Nantes Universite, Nantes, France.
Seminars in respiratory and critical care medicine
|September 3, 2025
概括
通过减少炎症,葡萄糖皮质激素作为医院获得的肺炎 (HAP) 和呼吸机相关的肺炎 (VAP) 的辅助疗法具有前景. 需要进一步的研究来个性化对重症患者的使用,以改善结果.
科学领域:
- 危急护理医学
- 肺病学
- 免疫学
背景情况:
- 医院获得的肺炎 (HAP) 和呼吸机相关的肺炎 (VAP) 是重症患者常见的并发症.
- 目前的治疗方法,包括抗生素,
- 目前对于HAP和VAP没有标准的辅助疗法.
研究的目的:
- 探索葡萄皮质类药物作为HAP和VAP的免疫调节辅助疗法的潜力.
- 审查有关在这些疾病中使用皮质类固醇的现有证据和正在进行的研究.
- 讨论在HAP和VAP中优化皮质类固醇治疗的个性化方法.
主要方法:
- 对现有的文献和相关呼吸道疾病的发现进行了审查.
- 对创伤患者预防试验的初步数据进行分析.
- 讨论正在进行的随机对照试验.
主要成果:
- 通过调节过度的炎症,葡萄糖皮质类药物可以减少肺损伤并改善结果.
- 对HAP和VAP的证据有限,但对相关疾病 (例如,ARDS,COVID-19) 的研究显示了潜在的益处.
- 生物标志物引导的方法和正在进行的试验正在调查患者选择皮质类固醇治疗.
结论:
- 葡萄皮质类药物是对HAP和VAP的有希望的辅助策略,其抗炎作用得到了支持.
- 使用炎症生物标志物和考虑肺微生物组的个性化医疗方法对于优化疗效至关重要.
- 为了完善这些感染的患者选择和治疗策略,需要进行进一步的研究.
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