TY - JOUR T1 -静脉注射甲泼尼松龙脉冲治疗住院的COVID-19重症患者:随机对照临床试验结果JF -欧洲呼吸杂志》乔和J - 10.1183/13993003.02808 -2020欧元六世- 56 - 6 SP - 2002808 AU Edalatifard Maryam盟——Akhtari Maryam盟,萨利希Mohammadreza盟——Naderi Zohre盟——卷Ahmadreza AU -摩斯塔菲,扎非盟- Najafizadeh,赛义德Reza AU -蒂,Elham盟,贾利利Nooshin盟——Esfahani Masoud AU -拉希米,Besharat盟——Kazemzadeh Hossein盟——Mahmoodi Aliabadi Maedeh盟——Ghazanfari Tooba盟——Sattarian Mohammadreza盟——Ebrahimi Louyeh Hourvash AU - Raeeskarami,赛义德Reza盟——Jamalimoghadamsiahkali Saeidreza盟——Khajavirad Nasim盟——Mahmoudi马赫迪盟——RostamianAbdolrahman Y1 - 2020/12/01 UR - //www.qdcxjkg.com/content/56/6/2002808.abstract N2 -介绍目前还没有确定的治疗严重COVID-19的药物。提示甲基泼尼松龙作为一种免疫抑制治疗，可减轻COVID-19患者呼吸系统炎症。我们开展了一项单盲、随机对照临床试验，涉及伊朗确诊的COVID-19早期肺期重症住院患者。患者按1:1的比例，通过区块随机化方法随机分配，接受甲基泼尼松龙脉冲治疗(静脉注射，250 mg·d - 1，连续3天)或单独标准治疗。研究的终点是临床改善或死亡的时间，以先出现的时间为准。对意向治疗(ITT)人群进行了初步和安全性分析。2020年4月20日至2020年6月20日，对68例符合条件的患者进行了随机分组(每组34例)。 In the standard care group, six patients received corticosteroids by the attending physician before the treatment and were excluded from the overall analysis. The percentage of improved patients was higher in the methylprednisolone group than in the standard care group (94.1% versus 57.1%) and the mortality rate was significantly lower in the methylprednisolone group (5.9% versus 42.9%; p<0.001). We demonstrated that patients in the methylprednisolone group had a significantly increased survival time compared with patients in the standard care group (log-rank test: p<0.001; hazard ratio 0.293, 95% CI 0.154–0.556). Two patients (5.8%) in the methylprednisolone group and two patients (7.1%) in the standard care group showed severe adverse events between initiation of treatment and the end of the study.Conclusions Our results suggest that methylprednisolone pulse could be an efficient therapeutic agent for hospitalised severe COVID-19 patients at the pulmonary phase.This study showed that methylprednisolone pulse administration at the beginning of the early pulmonary phase of illness decreased the mortality rate and improved pulmonary involvement, oxygen saturation and inflammatory markers in COVID-19 patients https://bit.ly/3hik4JB ER -