TY - JOUR T1 -口服地塞米松辅助治疗社区获得性肺炎住院非icu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——Voorn g .保罗AU - van de加尔达Ewoudt M.W. AU - Bos, Jan w . AU -威廉背景研究表明，辅助静脉注射皮质类固醇治疗可缩短因社区获得性肺炎(CAP)住院的成人的住院时间(LOS)。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相关。方法:在这项多中心、分层、随机、双盲、安慰剂对照试验中，在荷兰的四所教学医院，将具有免疫能力的CAP成人随机分配(1:1比例)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(肺炎严重指数I-III级和IV-V级)分层。主要结局为LOS。在2012年12月至2018年11月期间，401名患者被随机分配接受地塞米松(n=203)或安慰剂(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 -