摘要
目的进行糖皮质激素用于新型冠状病毒(SARS-CoV-2)感染、严重急性呼吸综合征(SARS)和急性呼吸窘迫综合征(ARDS)的安全性荟萃分析,以评估激素在重症新型冠状病毒肺炎(COVID-19)治疗中的安全性。方法检索PubMed、Embase、Cochrane Library、CNKI、万方数据库等公开发表的文献,检索时间截止到2020年6月1日,检索有关糖皮质激素对SARS-CoV-2感染、SARS和ARDS的死亡率影响,使用Stata软件进行荟萃分析。结果共纳入有关COVID-195篇、ARDS 22篇、SARS 7篇。结果显示糖皮质激素联合常规治疗可以降低ARDS的死亡率,差异有统计学意义。糖皮质激素联合常规治疗与常规治疗相比,SARS与COVID-19的病死率差异无统计学意义。激素组在治疗分配不是随机的,临床上更倾向于在重症患者中使用,因此激素组重症的构成比高于非激素组。在一定意义上证明激素联合常规治疗降低了重症患者的死亡率。结论在重症COVID-19中,糖皮质激素的治疗对降低死亡率上有一定意义。但需要更多的随机对照研究才能得出实质性结论。
Objective We conducted a meta-analysis to address the safety of glucocorticoids in management of SARS-CoV-2 infection,severe acute respiratory syndrome(SARS),or acute respiratory distress syndrome(ARDS)to assess the safety of glucocorticoids in severe coronavirus disease 2019(COVID-19)cases.Methods PubMed,Embase,the Cochrane Library,and CNKI databases were searched with publication time limit up to June 2020 to retrieve relevant references regarding glucocorticoids for mortality of SARS-CoV-2,infection,SARS and ARDS patients.Stata software was used for meta-analysis.Results As a result,5 reports on COVID-19,22 papers about ARDS,and 7 studies of SARS were included.Meta-analysis showed that glucocorticoids combined with conventional treatment significantly reduced the mortality rate of ARDS patients.Compared with conventional treatment without glucocorticoids,conventional treatment combined with glucocorticoids did not show statistically significant difference in mortality of SARS or COVID-19 patients.Glucocorticoids were not allocated to patients randomly and probably prescribed to severe patients in the reports.Generally,the patients receiving glucocorticoids were more likely at critical condition than the patients receiving conventional treatment alone.Conclusions Glucocorticoids therapy may play a role in reducing the mortality of severe COVID-19 cases.But more randomized controlled trials are needed to draw convincing conclusions.
作者
高安
陆圣威
陈丽
甘建和
孙蔚
GAO An;LU Shengwei;CHEN Li;GAN Jianhe;SUN Wei(Department of Infectious Diseases,the First People's Hospital of Kunshan,Kunshan Jiangsu 215300,China)
出处
《中国感染与化疗杂志》
CAS
CSCD
北大核心
2021年第4期411-417,共7页
Chinese Journal of Infection and Chemotherapy
基金
北京康盟慈善基金(B21039ES)。
