口服地塞米松辅助治疗非icu住院的社区获得性肺炎患者:随机临床试验摩根富林明欧洲呼吸杂志乔和J FD欧元欧洲呼吸学会SP 2002535 10.1183/13993003.02535 -2020签证官58 2 A188bet官网地址1 Wittermans,以斯帖A1 Vestjens, Stefan M.T. A1 Spoorenberg,西蒙·贝拉A1勃洛克,威廉l . A1格拉特案的裁决,Jan c A1詹森,Rob A1 Rijkers蒙古包t A1 Smeenk,弗兰克W.J.M. A1 Voorn,g .保罗A1 van de加尔达Ewoudt M.W. A1 Bos,威廉Jan w . A1 Santeon-CAP研究小组2021年UL //www.qdcxjkg.com/content/58/2/2002535.abstract AB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，以及这种影响是否取决于疾病的严重程度。在这项多中心、分层随机、双盲、安慰剂对照试验中，免疫能力强的CAP患者被随机分配(1:1)在荷兰的四所教学医院接受口服地塞米松(每日6 mg)或安慰剂治疗4天。随机分组(四组)按CAP严重程度(肺炎严重程度指数I-III级和IV-V级)分层。主要结果是LOS。2012年12月至2018年11月，401例患者随机接受地塞米松治疗(n=203)或安慰剂治疗(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