Department of Respiratory and Critical Care Medicine, The Second Hospital of Jilin University, Changchun, Jilin, China.
Department of Nuclear Medicine, The Second Hospital of Jilin University, Changchun, Jilin, China.
Sci Rep. 2024 Oct 23;14(1):25023. doi: 10.1038/s41598-024-76400-2.
Accumulating evidence supports that glucocorticoid treatment for viral pneumonia (VPA) can shorten the disease course and improve survival. However, currently, the use of glucocorticoids in treating VPA remains controversial. Moreover, a unified standard for the dosage and duration of glucocorticoid therapy has not been presented in published articles. A retrospective analysis was conducted in patients who were hospitalized for severe influenza virus-associated pneumonia, and they received sequential treatment with high-dose glucocorticoids and short-course oral glucocorticoids. Patients were followed up for 3 months. A total of 11 patients were included in the study (average age 56 years). There was no gender difference, but age and underlying diseases could be risk factors for severe influenza virus-associated pneumonia. The types of viruses causing pneumonia included influenza A/B. The main clinical symptoms of patients were fever, cough, sputum production, and dyspnea. Chest computed tomography showed multiple ground-glass shadows in the lobes, and the presence of bacterial and fungal infections was accompanied by consolidation shadows. After glucocorticoid therapy, the symptoms improved. None of the patients underwent tracheal intubation, and all survived. After a 3-month follow-up, lung CT absorption in all patients had reached more than 80%, and lung imaging absorption in 20% patients was complete. No serious complications occurred in any of the patients. Sequential treatment with high-dose steroids and short-course oral glucocorticoids may be helpful for reducing the tracheal intubation rate and mortality rate in patients with severe influenza virus-associated pneumonia. Additionally, short-course oral glucocorticoids may reduce pulmonary fibrosis in patients with severe influenza virus-associated pneumonia without any serious complications.
越来越多的证据支持糖皮质激素治疗病毒性肺炎（VPA）可以缩短病程并提高生存率。然而，目前糖皮质激素治疗 VPA 的应用仍存在争议。此外，发表的文章中尚未提出糖皮质激素治疗的剂量和疗程的统一标准。对因严重流感病毒相关性肺炎住院的患者进行了回顾性分析，他们接受了大剂量糖皮质激素序贯治疗和短疗程口服糖皮质激素治疗。对患者进行了 3 个月的随访。本研究共纳入 11 例患者（平均年龄 56 岁）。患者无性别差异，但年龄和基础疾病可能是严重流感病毒相关性肺炎的危险因素。引起肺炎的病毒类型包括流感 A/B。患者的主要临床症状为发热、咳嗽、咳痰和呼吸困难。胸部计算机断层扫描显示多个肺叶磨玻璃影，存在细菌和真菌感染时伴有实变影。糖皮质激素治疗后症状改善。所有患者均未行气管插管，均存活。3 个月随访时，所有患者的肺部 CT 吸收率均达到 80%以上，20%患者的肺部影像学吸收率完全。所有患者均未发生严重并发症。大剂量类固醇和短疗程口服糖皮质激素序贯治疗可能有助于降低严重流感病毒相关性肺炎患者的气管插管率和死亡率。此外，短疗程口服糖皮质激素可能会减少严重流感病毒相关性肺炎患者的肺纤维化，且无严重并发症。
