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糖皮质激素治疗 COVID-19 肺炎患者的临床疗效:一项单中心经验。

Clinical efficacy of glucocorticoid on the treatment of patients with COVID-19 pneumonia: A single-center experience.

机构信息

Wuhan Pulmonary Hospital, Wuhan Institute for Tuberculosis Control, Wuhan 430030, Hubei, China.

Wuhan Pulmonary Hospital, Wuhan Institute for Tuberculosis Control, Wuhan 430030, Hubei, China.

出版信息

Biomed Pharmacother. 2020 Oct;130:110529. doi: 10.1016/j.biopha.2020.110529. Epub 2020 Jul 28.

Abstract

The aim of the present study was to identify the clinical efficacy of glucocorticoid therapy on the treatment of patients with Coronavirus Disease 2019 (COVID-19) pneumonia. Clinical and laboratory parameters were collected from 308 patients with COVID-19 pneumonia from the fever clinic of Wuhan Pulmonary Hospital (Wuhan City, Hubei Province, China) between January 14, 2020 and February 9, 2020, of which 216 patients received low-dose (equivalent of methylprednisolone 0.75-1.5 mg/kg/d) glucocorticoid treatment. The effect of glucocorticoid on imaging progress, adverse events, nucleic acid results and the outcomes were investigated. Lymphocyte count and C-reactive protein (CRP) significantly differed between the glucocorticoid therapy and non-glucocorticoid therapy groups. Compared with the non-glucocorticoid therapy group, glucocorticoid therapy did not significantly influence the clinical course of COVID-19 pneumonia, including imaging progress and the time duration for negative transformation of nucleic acid. Glucocorticoid therapy did not significantly influence the outcomes nor the adverse events of COVID-19 pneumonia. For the treatment of COVID-19 pneumonia, systemic and in-depth investigation is needed to determine the timing and dosage of glucocorticoids needed to inhibit overwhelming inflammatory response and not the protective immune response to COVID-19 pneumonia.

摘要

本研究旨在探讨糖皮质激素治疗 2019 冠状病毒病(COVID-19)肺炎患者的临床疗效。2020 年 1 月 14 日至 2 月 9 日,我们收集了 308 例来自中国湖北省武汉市肺科医院发热门诊的 COVID-19 肺炎患者的临床和实验室参数,其中 216 例患者接受了低剂量(相当于甲泼尼龙 0.75-1.5mg/kg/d)糖皮质激素治疗。研究了糖皮质激素对影像学进展、不良事件、核酸结果和结局的影响。糖皮质激素治疗组与非糖皮质激素治疗组之间的淋巴细胞计数和 C 反应蛋白(CRP)差异有统计学意义。与非糖皮质激素治疗组相比,糖皮质激素治疗并未显著影响 COVID-19 肺炎的临床病程,包括影像学进展和核酸转阴的时间。糖皮质激素治疗也未显著影响 COVID-19 肺炎的结局或不良事件。对于 COVID-19 肺炎的治疗,需要进行系统和深入的研究,以确定抑制过度炎症反应所需的糖皮质激素的时机和剂量,而不是对 COVID-19 肺炎的保护性免疫反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/231c/7386262/54279a32432e/ga1_lrg.jpg

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