Treatment of severe acute respiratory syndrome with glucosteroids: the Guangzhou experience.
Treatment of severe acute respiratory syndrome with glucosteroids: the Guangzhou experience.
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用糖固醇治疗严重的急性呼吸道综合征：广州体验。
DOI：
10.1378/chest.129.6.1441
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发表时间：
2006-06
期刊：
影响因子：
9.6
通讯作者：
Zhong N
中科院分区：
文献类型：
--
作者：
Chen RC;Tang XP;Tan SY;Liang BL;Wan ZY;Fang JQ;Zhong N
目的探讨糖皮质激素治疗严重急性呼吸综合征（SARS）的疗效和安全性。2002年12月至2003年6月，中国广州治疗的1,278例SARS病例中有401例符合世界卫生组织发布的SARS确诊诊断标准。其中，重症SARS的诊断是根据SARS指南的标准结合低氧合指数（OI）[< 300 mm Hg]来定义的。通过logistic回归和考克斯回归对从数据库中检索到的这些患者的数据进行回顾性分析，以了解皮质类固醇治疗对死亡、住院天数和并发症的影响。在研究的401例SARS患者中，249例非危重患者中有147例（59.0%）接受了皮质类固醇（平均日剂量，105.3 ± 86.1 mg）[± SD]，所有患者均存活; 152例危重患者中有121例（79.6%）接受了皮质类固醇（平均日剂量，133.5 ± 102.3 mg），25例死亡。对这401例确诊病例的分析未显示皮质类固醇对死亡率和住院天数有任何益处。然而，当集中在152例危重SARS病例中时，单因素分析显示与这些终点相关的因素包括使用皮质类固醇、年龄、发病时寒战、继发性呼吸道感染、肺部罗音、OI分级和使用有创通气。在调整可能的混杂因素后，皮质类固醇治疗有助于降低总死亡率、即时死亡率和缩短住院时间（p < 0.05）。并发症的发生率与有创通气的需要显著相关，但与皮质类固醇的使用无关。本回顾性研究显示，在确诊的重症SARS患者中，适当使用糖皮质激素可降低死亡率和缩短住院时间，且与继发下呼吸道感染和其他并发症无明显相关性。
To investigate the efficacy and safety profiles of corticosteroid therapy in severe acute respiratory syndrome (SARS) patients. Four hundred one of 1,278 SARS cases treated in Guangzhou China between December 2002 and June 2003 fulfilled the diagnostic criteria issued by the World Health Organization for confirmed identification of SARS. Among them, the diagnosis of critical SARS was defined by criteria of SARS guidelines incorporated with a low oxygenation index (OI) [< 300 mm Hg]. Data of these patients retrieved from a database were retrospectively analyzed by logistic regression and Cox regression for the effect of corticosteroid therapy on death, hospitalization days, and complication presentation. Among the 401 SARS patients studied, 147 of 249 noncritical patients (59.0%) received corticosteroids (mean daily dose, 105.3 ± 86.1 mg) [± SD], and all survived the disease; 121 of 152 critical patients (79.6%) received corticosteroids at a mean daily dose of 133.5 ± 102.3 mg, and 25 died. Analysis of these 401 confirmed cases did not show any benefits of corticosteroid on the death rate and hospitalization days. However, when focused on 152 critical SARS cases, factors correlated with these end points indicated by univariate analysis included use of corticosteroid, age, rigor at onset, secondary respiratory infections, pulmonary rales, grading of OI, and use of invasive ventilation. After adjustment for possible confounders, treatment with corticosteroid was shown contributing to lower overall mortality, instant mortality, and shorter hospitalization stay (p < 0.05). Incidence of complications was significantly associated with the need for invasive ventilation but not with use of corticosteroids. This Guangzhou retrospective study revealed that proper use of corticosteroid in confirmed critical SARS resulted in lowered mortality and shorter hospitalization stay, and was not associated with significant secondary lower respiratory infection and other complications.
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影响因子：
6.9
作者：
Tsang, K;Zhong, NS
通讯作者：
Zhong, NS
DOI：
10.1164/ajrccm.165.7.2106014
发表时间：
2002-04-01
影响因子：
24.7
作者：
Meduri, GU;Tolley, EA;Stentz, F
通讯作者：
Stentz, F
DOI：
10.1164/rccm.200306-766oc
发表时间：
2003-12-15
影响因子：
24.7
作者：
Ho, JC;Ooi, GC;Tsang, KW
通讯作者：
Tsang, KW
影响因子：
158.5
作者：
BERNARD, GR;LUCE, JM;BRIGHAM, KL
通讯作者：
BRIGHAM, KL
DOI：
10.1016/s0140-6736(03)13265-5
发表时间：
2003-05-10
期刊：
Lancet (London, England)
影响因子：
--
作者：
So LK;Lau AC;Yam LY;Cheung TM;Poon E;Yung RW;Yuen KY
通讯作者：
Yuen KY