在社区获得的肺炎中使用葡萄糖皮质激素治疗
Pierre-François Dequin1,2,3, Marco Confalonieri4,5
1Inserm UMR 1100 Centre d'Etudes des Pathologies Respiratoires, Université de Tours, Tours, France.
皮质类固醇可能有助于一些患有社区性肺炎的患者,但它们的使用仍然存在争议. 需要进一步的研究来确定哪些患者从这种治疗中获益最多.
科学领域:
- 肺部病理学 肺部病理学
- 临界护理医学 临界护理医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 皮质类固醇在社区获得性肺炎 (CAP) 治疗中的作用是有争议的,尽管有许多试验.
- 最近在重症监护室 (ICU) 进行的高强度随机试验提供了相互矛盾的见解.
研究的目的:
- 为了澄清皮质类固醇在农业农业政策管理中的有争议的作用.
- 确定可能从皮质类固醇治疗中受益的患者子组.
- 改进针对特定病原体相关肺炎的皮质类固醇的指示.
主要方法:
- 审查和分析现有的比较试验和最近的随机对照试验.
- 专注于重症监护室 (ICU) 患者群体.
- 探索针对性治疗的患者表型.
主要成果:
- 最近ICU试验的相互矛盾结果需要进一步调查.
- 在COVID-19肺炎中确立了皮质类固醇的益处.
- 对于病毒性肺炎的适应症需要细化;不推用于流感.
- 在选定的患者群体中,短期使用似乎是安全的.
结论:
- 更精确的患者表型为优化CAP中皮质类固醇使用至关重要.
- 皮质类固醇对COVID-19肺炎有益.
- 需要仔细考虑特定的病原体对皮质类固醇的适用性.
- 短期的皮质类固醇治疗通常对特定的CAP患者是安全的.
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