皮质类固醇治疗SARS-CoV-2相关肺部疾病

V. T. Ivaschkin, O. Zolnikova, A. Svistunov, N. Dzhakhaya, N. Potskhverashvili, N. Kokina, E. R. Buklis, T. V. Roshchina, I. Komkova, M. Nadinskaia
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引用次数: 1

摘要

的目标。探讨糖皮质激素治疗SARS-CoV-2肺损伤的疗效。材料和方法。回顾性研究纳入了经计算机断层扫描(CT)诊断为确诊的SARS-CoV-2感染和肺损伤的患者,这些患者正在接受低分子肝素(LMWH)治疗。第1组56例患者入院后给予地塞米松4 ~ 12 mg/d,持续8 ~ 10天。2组30例(对照组)未进行地塞米松治疗。对入院患者和治疗8 - 10天的实验室和仪器数据进行分析。采用Kaplan - Meier法评价住院死亡率。为了预测致命的结果,我们使用了逻辑回归方法。结果。住院第8 ~ 10天,只有1组CT肺组织病变体积(p = 0.027)、纤维蛋白原浓度(p = 0.001)下降有统计学意义。两组c反应蛋白浓度均有统计学意义的降低。2组(26例,87%)比1组(36例,64%)需氧量更高(p = 0.028)。第1组住院死亡率为3.6%,第2组为13.3% (p = 0.177)。第1组患者在住院18 ~ 28天生存率有增加的趋势(Mantel - Cox检验,p = 0.095)。logistic回归方程包括年龄(p = 0.012)、入院时CT病变百分比(p = 0.020)和地塞米松组分配(p = 0.080)。对于SARS-CoV-2肺损伤患者,从入院第一天开始给予地塞米松4-12 mg治疗,加上低分子肝素治疗,有助于8 - 10天CT动态阳性,降低住院死亡率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Corticosteroids in the treatment of SARS-CoV-2 related lung disease
Aim. To explore the effectiveness of corticosteroids in patients with lung damage caused by SARS-CoV-2.Materials and methods. The retrospective study included patients with confirmed SARS-CoV-2 infection and lung damage diagnosed by computed tomography (CT), who was receiving low molecular weight heparin (LMWH). 56 patients included in Group 1 received dexamethasone 4–12 mg/day for 8–10 days after admission to the hospital. 30 patients included in Group 2 (control group) had no dexamethasone treatment. The laboratory and instrumental data obtained from the patients under admission and for the 8–10th day of the treatment were analyzed. Hospital mortality was evaluated by Kaplan — Meier method. To predict a lethal outcome, we have used the logistic regression method. Results. By the 8–10th day of hospitalization, only in the Group 1, there was a statistically significant decrease in the volume of lung tissue lesions by CT (p = 0.027), fibrinogen concentration (p = 0.001). A statistically significant decrease of the C-reactive protein concentration was noted for the both groups. Oxygen therapy was more often needed in Group 2 (26 patients — 87%) in opposite to Group 1 (36 patients — 64%) (p = 0.028). Hospital mortality was 3.6% in Group 1 and 13.3% in Group 2 (p = 0.177). There was a trend towards an increase in patient survival in Group 1 between 18 and 28 days of hospitalization (Mantel — Cox test, p = 0.095). Age (p = 0.012), percentage of CT lesions at the time of admission (p = 0.020) and assignment to the dexamethasone group (p = 0.080) were included in the logistic regression equation.Conclusion. For the patients with SARS-CoV-2 lung damage, treatment with dexamethasone 4–12 mg, started from the first day of hospitalization additionally to LMWH, contributes to positive CT dynamics on the 8–10th day and decreases hospital mortality.
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