糖皮质激素在艾滋病合并卡氏肺孢子虫肺炎中的应用

The effect of glucocorticoids on pneumocystis carinii pneumonia in patients with acquired immunodeficiency syndrome

目的探讨糖皮质激素在治疗艾滋病合并PCP中对氧合功能及短期预后的作用。方法回顾性分析2005～2008年艾滋病合并PCP病例58例,氧合指数作为糖皮质激素疗效的判别指标,采用方差分析分析糖皮质激素的疗效。结果58例中有43例(74.1%)使用糖皮质激素;所有患者经糖皮质激素治疗后氧合指数均有提高;糖皮质激素治疗后氧合指数在有糖皮质激素应用指征组和无指征组的升高幅度差异无统计学意义;糖皮质激素治疗前后氧合指数差值随治疗前氧合指数水平升高而下降。未出现糖皮质激素相关严重不良反应。结论在艾滋病合并PCP治疗中,适当应用糖皮质激素,对减轻患者肺部症状、改善氧合功能有一定疗效,特别是对于治疗前氧合指数水平较低者(氧合指数≤300mmHg)的肺功能改善更明显。

Objective To investigate the effect of glucocorticoids on pulmonary oxygenation function and Short-term prognosis Of pneumocystis earinii pneumonia（PCP） in patients with AIDS. Methods 58 PCP patients with AIDS from 2005 to 2008 were analyzed retrospectively. Oxygenation index （OI） was considered as marker of Glucocorticoids therapeutic effects. The therapeutic effects of Glucocorticoids were analyzed by analysis of variance. Results Glucocortieoids were used in 74. 1% （43/58） of PCP with AIDS cases. All the case＇ s OI have significantly increased after glucocorticoids treatment, there was no significant difference between the groups had application indication and the groups without application indication. The OI difference before and after glucocorticoids treatment was decreased with the increasing OI before treatment. There was no glucocorticolds-related serious adverse reactions were observed. Conclusion The PCP patients with AIDS could obtain pulmonary symptoms and function improvements with appropriate glucocorticoids treatment, especially for those OI less than 300 mm Hg before treatment.