TY - JOUR T1 -口服地塞米松辅助治疗非icu社区获得性肺炎患者:随机临床试验JF -欧洲呼吸杂志》乔和J - 10.1183/13993003.02535 -2020欧元六世- 58 - 2 SP - 2002535 AU Wittermans以斯帖盟——Vestjens Stefan M.T.盟——Spoorenberg西蒙尼·贝拉AU -勃洛克,威廉l . AU -格拉特案的裁决,Jan c . AU -詹森,Rob AU - Rijkers蒙古包t . AU - Smeenk,弗兰克W.J.M.盟——Voorng .保罗AU - van de加尔达Ewoudt M.W. AU - Bos,威廉1月w . AU - Santeon-CAP研究小组Y1 - 2021/08/01 UR - //www.qdcxjkg.com/content/58/2/2002535.abstract N2 -背景辅助静脉注射皮质类固醇治疗被证明能减少的长度(LOS)呆在医院治疗社区获得性肺炎(CAP)的成年人。我们的目的是评估口服地塞米松对LOS的影响，以及这种影响是否与疾病严重程度有关。本研究采用多中心、分层、随机、双盲、安慰剂对照的方法，在荷兰的4家教学医院中，将具有免疫能力的CAP成人患者随机分配(1:1)接受口服地塞米松(6mg，每日1次)或安慰剂，为期4天。根据CAP严重程度(肺炎严重程度指数I-III级和IV-V级)进行随机分组(4个区)。主要结果为LOS。2012年12月至2018年11月，401例患者随机接受地塞米松(n=203)或安慰剂(n=198)。地塞米松组(4.5天，95% CI 4.0-5.0天)的中位LOS短于安慰剂组(5.0天，95% CI 4.6-5.4天;p = 0.033)。 Within both CAP severity subgroups, differences in LOS between treatment groups were not statistically significant. The secondary ICU admission rate was lower in the dexamethasone arm (5 (3%) versus 14 (7%); p=0.030); 30-day mortality did not differ between groups. In the dexamethasone group the rate of hospital readmission tended to be higher (20 (10%) versus 9 (5%); p=0.051) and hyperglycaemia (14 (7%) versus 1 (1%); p=0.001) was more prevalent.Conclusion Oral dexamethasone reduced LOS and ICU admission rate in adults hospitalised with CAP. It remains unclear for which patients the risk–benefit ratio is optimal.Adjunctive treatment with oral dexamethasone in adults hospitalised with community-acquired pneumonia (CAP) reduced length of stay and ICU admission rate. However, it remains unclear for which CAP subgroup the risk–benefit ratio is optimal. https://bit.ly/35tXfPX ER -