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《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:

期数:

2020年04期

页码:

497-500

栏目:

论著

出版日期:

2020-08-20

文章信息/Info

Title:

Effect of glucocorticoids on treatment of common patients with corona virus disease-2019

作者:

张玉坤¹ 江 兵¹ 杨时光¹ 王秋琼¹ 曾 鸣¹ 杨和平² 秦光梅¹

402160 重庆,重庆医科大学附属永川医院呼吸与危重症医学科¹ 401147 重庆,重庆北部宽仁医院呼吸内科²

Author(s):

Zhang Yukun¹;  Jiang Bing¹;  Yang Shiguang¹;  Wang Qiuqiong¹;  Zeng Ming¹;  Yang Heping²;  Qin Guangmei¹.

¹Department of Respiratory and Critical Care Medicine, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, China; ²Department of Respiratory Medicine, Chungking General Hospital, Chongqing 401147, China
Corresponding author

关键词:

新冠病毒病;  糖皮质激素;  普通型

Keywords:

Coronavirus disease 2019;  Glucocorticoid;  Common type

分类号:

R563

DOI:

10.3877/cma.j.issn.1674-6902.2020.04.014

摘要:

目的 探讨糖皮质激素在普通冠状病毒病(COVID-19)患者治疗中的作用。方法 对2020年1月24日至3月5日在我院救治的COVID-19的51例普通型患者进行回顾性分析研究。根据患者发热、炎症指标、胸部CT等,充分评估患者发展为重型/危重型的风险,将患者分为低危组19例、中危组21例、高危组11例,高危组给予早期、小剂量、短疗程糖皮质激素治疗。结果 三组在性别和年龄构成比上无统计学差异(P>0.05); 三组患者平均住院天数及核酸平均转阴天数均无统计学差异(P>0.05); 高危组较中危组及低危组患者入院时C-反应蛋白比较有统计学差异(P<0.05); 高危组较中危组白介素-6差异无统计学意义(P=0.552),但两组较低危组比较差异均具有统计学意义(P<0.05); 高危组、中危组较、低危组入院时外周血淋巴细胞总数有差异(P<0.05),但高危组出院时淋巴细胞总数较入院时无差异(P>0.05)。结论 对COVID-2019普通型部分患者早期使用小剂量、短疗程的糖皮质激素,具有快速抑制炎症反应,阻断其向重型/危重型转化的可能,在新冠肺炎的救治中有一定的临床应用价值。

Abstract:

Objective To investigate the role of glucocorticoids in the treatment of the patients with novel coronavirus pneumonia(corona virus disease-2019, COVID-19). Methods An exploratory study was performed on the 51 patients with COVID-19 treated in our hospital from January 24 to March 5, 2020. We fully evaluated the risk of the patients developing into severe/critically severe types according to the patients'fever, inflammation index, and chest CT, etc. The patients were divided into a low-risk group(n=19), a medium-risk group(n=21)and a high-risk group(n=11). The high-risk group was given early, small dose and short course of glucocorticoids treatment. Results There was no statistical difference in the gender and age composition among the three groups(P>0.05), and there was no statistical difference in the average hospitalization days and the average number of days of negative nucleic acid transfer among the three groups, either(P>0.05). However, there was significant difference in C-reactive protein(CRP)between the high-risk group and the low-risk group(P<0.05). There was no significant difference in interleukin-6(IL-6)between the high-risk group and the middle-risk group(P=0.552), but there was significant difference between the two groups and the low-risk group(P<0.05). On patients'admission, the total lymphocytes in the peripheral blood in the high-risk group and the middle-risk group were different from that of the low risk group(P<0.05). However, at patients'discharge, there was no statistical difference in the total lymphocytes in the high-risk group(P>0.05)compared with that on admission. Conclusion The early use of small dose and short course of glucocorticoids in the patients with common type of COVID-19 has the possibility of rapidly inhibiting the inflammatory response and blocking the development into severe/critical types, which may have certain clinical application values.

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备注/Memo

备注/Memo:

基金项目: 重庆医科大学附属永川医院新冠肺炎防控应急科研专项项目
通信作者: 秦光梅, Email: 2683958170@qq.com

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更新日期/Last Update: 2020-08-20