肺炎支原体肺炎患者早期使用皮质类固醇治疗：一项随机临床试验。

Early treatment with corticosteroids in patients with Mycoplasma pneumoniae pneumonia: a randomized clinical trial.

作者信息

Huang Lizhen, Gao Xiang, Chen Meiyuan

机构信息

Department of Pediatrics, The First People's Hospital of Wujiang, Wujiang 215200, Jiangsu, China.

Department of Pediatrics, The First People's Hospital of Wujiang, Wujiang 215200, Jiangsu, China

出版信息

J Trop Pediatr. 2014 Oct;60(5):338-42. doi: 10.1093/tropej/fmu022. Epub 2014 Apr 7.

DOI:10.1093/tropej/fmu022

PMID:24710342

Abstract

BACKGROUND

Corticosteroids have been evaluated for management of severe Mycoplasma pneumoniae pneumonia (MP) in children. However, it is unclear whether the timing of treatment with corticosteroids affects the patients' clinical outcome.

METHODS

We did a prospective randomized clinical trial to evaluate the effect of early use of corticosteroids. Fifty-three patients were randomly assigned to treatment with corticosteroids within 24 h after admission (cases), and 53 patients were treated 72 h after admission (control patients).

RESULTS

Cases had a shorter fever duration [6 days (range 5-11) vs. 10 days (range 8-23), p < 0.001] and length of hospital stay [8 days (range 5-15) vs. 10 days (range 5-21), p = 0.001]. Four cases (1.9%) had a complete radiographic resolution time >4 weeks compared with 10 control patients (17.5%; p = 0.038; Table 2).

CONCLUSIONS

Early treatment with corticosteroids was associated with a better outcome in patients with severe MP.

摘要

背景

已对皮质类固醇用于儿童重症肺炎支原体肺炎（MP）的治疗进行了评估。然而，皮质类固醇治疗的时机是否会影响患者的临床结局尚不清楚。

方法

我们进行了一项前瞻性随机临床试验，以评估早期使用皮质类固醇的效果。53例患者在入院后24小时内被随机分配接受皮质类固醇治疗（病例组），53例患者在入院后72小时接受治疗（对照组）。

结果

病例组发热持续时间较短[6天（范围5 - 11天）对10天（范围8 - 23天），p < 0.001]，住院时间较短[8天（范围5 - 15天）对10天（范围5 - 21天），p = 0.001]。4例（1.9%）患者的影像学完全消退时间>4周，而对照组有10例患者（17.5%）；p = 0.038（表2）。