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中华肺部疾病杂志(电子版) ›› 2020, Vol. 13 ›› Issue (04) : 497 -500. doi: 10.3877/cma.j.issn.1674-6902.2020.04.014

论著

糖皮质激素在普通型新冠肺炎治疗中的探索
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,()   
  1. 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
    2. 401147 重庆,重庆北部宽仁医院呼吸内科
  • 收稿日期:2020-02-21 出版日期:2020-08-25
  • 通信作者: 秦光梅

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

Yukun Zhang1, Bing Jiang1, Shiguang Yang1, Qiuqiong Wang1, Ming Zeng1, Heping Yang2, Guangmei Qin1,()   

  1. 1. Department of Respiratory and Critical Care Medicine, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, China
    2. Department of Respiratory Medicine, Chungking General Hospital, Chongqing 401147, China
  • Received:2020-02-21 Published:2020-08-25
  • Corresponding author: Guangmei Qin
引用本文:

张玉坤, 江兵, 杨时光, 王秋琼, 曾鸣, 杨和平, 秦光梅. 糖皮质激素在普通型新冠肺炎治疗中的探索[J]. 中华肺部疾病杂志(电子版), 2020, 13(04): 497-500.

Yukun Zhang, Bing Jiang, Shiguang Yang, Qiuqiong Wang, Ming Zeng, Heping Yang, Guangmei Qin. Effect of glucocorticoids on treatment of common patients with corona virus disease-2019[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2020, 13(04): 497-500.

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。

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.

表1 各组患者入院时CRP、IL-6及外周血L淋巴细胞计数的比较
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