TY - JOUR T1 -口服地塞米松辅助治疗非icu患者的社区获得性肺炎: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，以及这种影响是否依赖于疾病的严重程度。在这项多中心、分层随机、双盲、安慰剂对照试验中，免疫正常的CAP成人患者在荷兰四所教学医院随机(1:1比例)接受口服地塞米松(6mg，每日一次)或安慰剂，为期4天。随机分组(四组)按CAP严重程度分层(肺炎严重程度指数I-III级和IV-V级)。主要结果为LOS。在2012年12月至2018年11月期间，401名患者被随机分为地塞米松组(n=203)和安慰剂组(n=198)。地塞米松组的中位LOS(4.5天，95% CI 4.0-5.0天)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 -