Department of Infectious Diseases, Hospital Universitari de Bellvitge, University of Barcelona, Feixa Llarga s/n, Barcelona, Spain.
J Infect. 2011 Mar;62(3):193-9. doi: 10.1016/j.jinf.2011.01.014. Epub 2011 Feb 3.
To determine the effect of immunomodulatory therapies on the development of severe disease in hospitalized adults with laboratory-confirmed pandemic influenza A (H1N1) 2009 complicated by pneumonia.
Observational, prospective cohort study at thirteen tertiary hospitals in Spain. The use of corticosteroids, macrolides and statins was recorded. The outcome of interest was severe disease, defined as the composite of intensive care unit admission or death after the first day of hospitalization.
Of the 197 patients with pandemic influenza A (H1N1) 2009 complicated by pneumonia, 68 (34.5%) received some anti-inflammatory therapy since hospital admission (corticosteroids in 37, macrolides in 31 and statins in 12). Severe disease occurred in 29 (14.7%) patients. After adjustment for confounding factors, immunomodulatory therapies as a group were not associated with a lower risk for developing severe disease (odds ratio [OR] 0.64; 95% confidence interval [CI] 0.22-1.86). In a further a priori analysis, corticosteroids, macrolides and statins were included in a multivariate model. None of these therapies was found to be associated with a lower risk for developing severe disease.
Immunomodulatory therapies use since hospital admission did not prevent the development of severe disease in adults with pandemic influenza A (H1N1) 2009 complicated by pneumonia.
确定免疫调节疗法对住院成人甲型 H1N1 流感 2009 大流行并发肺炎患者发生严重疾病的影响。
这是在西班牙 13 家三级医院进行的观察性、前瞻性队列研究。记录了皮质类固醇、大环内酯类药物和他汀类药物的使用情况。感兴趣的结局是严重疾病，定义为住院后第一天入住重症监护病房或死亡的复合结局。
在 197 例甲型 H1N1 流感 2009 大流行并发肺炎患者中，68 例（34.5%）在住院后接受了某种抗炎治疗（皮质类固醇 37 例，大环内酯类药物 31 例，他汀类药物 12 例）。29 例（14.7%）患者发生严重疾病。在调整混杂因素后，免疫调节治疗作为一个整体与发生严重疾病的风险降低无关（比值比 [OR] 0.64；95%置信区间 [CI] 0.22-1.86）。在进一步的预先分析中，皮质类固醇、大环内酯类药物和他汀类药物被纳入多变量模型。这些治疗方法均未发现与发生严重疾病的风险降低相关。
住院后使用免疫调节疗法并不能预防甲型 H1N1 流感 2009 大流行并发肺炎的成年人发生严重疾病。
