地塞米松与调整体重后的甲基泼尼松龙治疗中重度 SARS-CoV-2 肺炎患者的比较。
Dexamethasone versus weight-adjusted methylprednisolone in patients with moderate-severe SARS-CoV-2 pneumonia.
机构信息
Servicio de Medicina Interna, Hospital Universitario Clínico San Cecilio, Granada, España; Instituto de Investigación Biosanitaria ibs.Granada, Granada, España.
Servicio de Medicina Interna, Hospital Universitario Clínico San Cecilio, Granada, España.
出版信息
Med Clin (Barc). 2023 Feb 24;160(4):156-159. doi: 10.1016/j.medcli.2022.06.015. Epub 2022 Jul 20.
OBJECTIVES
To compare the 30-day outcome (mortality and/or ICU admission) of patients admitted for moderate-severe SARS-CoV-2 pneumonia treated with dexamethasone after the Recovery study versus those treated with weight-adjusted methylprednisolone.
METHODS
Retrospective cohort study of 65 patients with moderate-severe pneumonia who received dexamethasone 6 mg/day (DXM group) versus 80 treated with weight-adjusted methylprednisolone (MTPN group).
RESULTS
Twenty-one (32.3%) patients in the DXM group died vs. 8 (10%) in the MTPN group (p-value < 0.001) and 29 (44.6%) in the DXM group required ICU admission vs. 2 (2.5%) of the MTPN group (p-value < 0.001). There were no baseline differences regarding sociodemographic characteristics with a higher mean qSOFA in the MTPN group. The hazard ratio for mortality and ICU admission adjusted for age, sex, and admission CRP was 2.189 (1.082-4.426; 95% CI) and 10.589 (2.139-48.347; 95% CI) for the DXM group, respectively, vs. MTPN group.
CONCLUSIONS
Mortality and admission to the ICU were lower in patients treated with weight-adjusted methylprednisolone compared to those treated with dexamethasone.
目的
比较在康复研究后接受地塞米松治疗的中重度 SARS-CoV-2 肺炎患者与接受体重调整甲基泼尼松龙治疗的患者的 30 天结局（死亡率和/或 ICU 入院）。
方法
回顾性队列研究了 65 名接受地塞米松 6 毫克/天（DXM 组）与 80 名接受体重调整甲基泼尼松龙（MTPN 组）治疗的中重度肺炎患者。
结果
DXM 组有 21 名（32.3%）患者死亡，而 MTPN 组有 8 名（10%）（p 值<0.001），DXM 组有 29 名（44.6%）患者需要入住 ICU，而 MTPN 组有 2 名（2.5%）（p 值<0.001）。两组在社会人口统计学特征方面没有基线差异，但 MTPN 组的平均 qSOFA 较高。在校正年龄、性别和入院 CRP 后，死亡和 ICU 入院的风险比分别为 DXM 组的 2.189（1.082-4.426；95%CI）和 10.589（2.139-48.347；95%CI），而 MTPN 组则为 1.082（0.554-2.139；95%CI）。
结论
与接受地塞米松治疗的患者相比，接受体重调整甲基泼尼松龙治疗的患者死亡率和 ICU 入院率较低。
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