TY - JOUR T1 -静脉注射甲泼尼龙脉冲治疗住院重症COVID-19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——Rostamian重症COVID-19没有确定的治疗药物。提示甲强的松龙作为一种免疫抑制疗法，可减轻COVID-19患者呼吸系统炎症。方法:我们进行了一项单盲、随机对照临床试验，涉及伊朗确诊COVID-19早期肺部阶段的重症住院患者。患者按1:1的比例随机分组，接受甲基泼尼松龙脉冲(静脉注射，250 mg·d - 1，连续3天)或单独接受标准治疗。研究终点为临床改善或死亡时间，以先到者为准。初步和安全性分析是在意向治疗(ITT)人群中进行的。从2020年4月20日至2020年6月20日，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 -