MacFadden D K, Edelson J D, Hyland R H, Rodriguez C H, Inouye T, Rebuck A S
Lancet. 1987 Jun 27;1(8548):1477-9. doi: 10.1016/s0140-6736(87)92219-7.
10 patients with the acquired immunodeficiency syndrome whose respiratory failure due to Pneumocystis carinii pneumonia (PCP) was deteriorating rapidly had 7 days of intravenous methylprednisolone added to their antibiotic regimen. 8 similar patients were treated with antibiotic therapy alone. 9 of the 10 methylprednisolone-treated patients survived their episode of PCP, compared with 2 of the 8 conventionally treated patients. Clinical improvement was evident within 2 days of the start of steroid therapy, and in none of the 10 patients did clinical deterioration or recurrence of PCP occur on cessation of steroid therapy. In 1 steroid-treated patient disseminated herpes zoster developed 2 days after discontinuation of methylprednisolone. Methylprednisolone seems to be a useful adjunctive therapeutic agent for patients with AIDS in whom Pneumocystis carinii is the sole respiratory pathogen.
10例因卡氏肺孢子虫肺炎（PCP）导致呼吸衰竭且病情迅速恶化的获得性免疫缺陷综合征患者，在其抗生素治疗方案中加入了7天的静脉注射甲泼尼龙。8例类似患者仅接受抗生素治疗。接受甲泼尼龙治疗的10例患者中有9例在PCP发作后存活，而8例接受传统治疗的患者中只有2例存活。在开始使用类固醇治疗后的2天内临床改善明显，并且在停止类固醇治疗后，10例患者中没有出现临床恶化或PCP复发的情况。在1例接受类固醇治疗的患者中，停用甲泼尼龙2天后发生了播散性带状疱疹。对于卡氏肺孢子虫是唯一呼吸道病原体的艾滋病患者，甲泼尼龙似乎是一种有用的辅助治疗药物。
