标题：甲强龙治疗重症社区获得性肺炎的疗效及其对患者血清C反应蛋白水平的影响

      作者：班健，罗雁，韦圳原    钦州市中医医院呼吸内科，广西 钦州 535000

      卷次： 2019年30卷1期

      【摘要】 目的 探讨甲强龙治疗重症社区获得性肺炎(SCAP)的疗效及其对患者血清C反应蛋白(CRP)水平的影响，以期为临床 SCAP治疗方案的选择提供依据。方法 选择钦州市中医医院呼吸内科于 2017年 1月至2018年 3月期间收治的 44例SCAP患者为研究对象，根据随机数表法分为观察组和对照组，每组 22例，对照组患者予常规抗感染治疗，观察组患者则在对照组基础上应用甲强龙治疗，疗程为 7 d。比较两组患者动脉血氧分压(PaO2)升高 10 mmHg时间、体温恢复正常时间、住院时间及二重感染发生情况和病死率，治疗前后测定血清CRP水平。结果 观察组患者PaO2升高10 mmHg的时间、体温恢复正常时间分别为(4.81±1.48) d、(3.39±0.88) d，均明显短于对照组的(7.06±2.37) d、(4.72±1.24) d，二重感染发生率为36.36%，明显高于对照组的13.64%，差异均有统计学意义(P<0.05)；两组患者的住院时间、病死率比较差异均无统计学意义(P>0.05)；治疗后，观察组患者的血清CRP水平为(31.45±18.72) mg/L，明显低于对照组的(51.24±20.53) mg/L，差异有统计学意义(P<0.05)。结论 常规抗感染等治疗的基础上应用甲强龙治疗重症社区获得性肺炎，可以有效降低血清炎症因子水平，加快患者氧合的改善及体温的恢复，但是甲强龙的应用有增加二重感染发生的风险。
      【关键词】 甲强龙；糖皮质激素；重症社区获得性肺炎；C反应蛋白；疗效
      【中图分类号】 R563.1 【文献标识码】 A 【文章编号】 1003—6350（2019）01—0035—03

Effect of methylprednisolone on severe community acquired pneumonia and its effect on serum C reactiveprotein.
BAN Jian, LUO Yan, WEI Zhen-yuan. Department of Respiratory Medicine, Qinzhou Traditional Chinese MedicineHospital, Qinzhou 535000, Guangxi, CHINA
【Abstract】 Objective To investigate the effect of methylprednisolone in the treatment of severe community ac-quired pneumonia (SCAP) and the effect on the level of serum C reactive protein (CRP), in order to provide a basis forthe clinical therapy selection of SCAP. Methods A total of 44 patients with SCAP in the Department of RespiratoryMedicine, Qinzhou Traditional Chinese Medicine Hospital from January 2017 to March 2018 were selected and dividedinto the observation group and the control group, each with 22 cases. The patients in the control group were treated withroutine anti-infection treatment, while those in the observation group were treated by methylprednisolone based on rou-tine anti-infection treatment. The treatment course was 7 days. The two groups of patients were compared on time of ar-terial oxygen pressure (PaO2) increasing by 10 mmHg, time of body temperature returning to normal, time of hospitaliza-tion, the incidence of double infection, and mortality. The serum levels of CRP were measured before and after treat-ment. Results The time of PaO2 increasing by 10 mmHg and time of body temperature returning to normal in the ob-servation group were (4.81±1.48) d, (3.39±0.88) d respectively, which were significantly shorter than (7.06±2.37) d,(4.72±1.24) d in the control group (P<0.05), and the incidence of double infection was 36.36%, significantly higher than13.64% of the control group (P<0.05). There was no significant difference in hospitalization time and mortality betweenthe two groups (P>0.05). After treatment, the serum CRP in the observation group was (31.45±18.72) mg/L, which wassignificantly lower than (51.24±20.53) mg/L in the control group (P<0.05). Conclusion Application of methylpredniso-lone in the treatment of severe community-acquired pneumonia on the basis of routine anti-infection treatment can effec-tively reduce the serum inflammatory factors, accelerate the improvement of oxygenation and the recovery of body tem-perature, but it has the risk of increasing the occurrence of double infection.
      【Key words】 Methylprednisolone; Glucocorticoid; Severe community acquired pneumonia; C reactive protein;Curative effect