地塞米松对儿童重症社区获得性肺炎的疗效研究

Therapeutic Effects of Dexamethasone on Children with Severe Community Acquired Pneumonia

目的探讨地塞米松对儿童社区获得性肺炎(CAP)的疗效。方法选择2009年1月至2011年6月巴中市中心医院儿科确诊为重症CAP患儿120例,随机分为试验组和对照组,两组均给予常规治疗,试验组在常规治疗基础上加用地塞米松治疗,疗程3 d。观察两组住院时间、血清C反应蛋白水平、总有效率、病死率及不良反应的发生率。结果与对照组比较,试验组住院天数少于对照组,但差异无统计学意义(P>0.05);试验组治疗3 d后血清C反应蛋白明显降低,差异有统计学意义(P<0.05);试验组总有效率明显高于对照组(P<0.05);但两组死亡率差异无统计学意义。结论地塞米松可明显降低重症CAP患儿炎症反应水平,减轻症状,但不能降低病死率和缩短住院时间。

Objective To investigate the therapeutic effect of dexamethas one on children with severe community acquired pneumonia（CAP）.Methods 120 c hildren with severe CAP admitted from January 2009 to June 2011 were recruited i n the study.The patients were randomly divided into a dexamethasone group（n= 62） and a control group（n=58）.The patients in the dexamethasone group receiv ed additional dexamethasone intravenous injection for 3 days（0.2-0.4 mg·kg-1·d-1,qd） on the basic treatment of the control group.Length of hospital st ay,serum Creactive protein（CRP） concentration on 4th day after admission,overall efficacy,mo rtality,incidence of adverse events during treatment were compared between the two groups.Results Median length hospital stay was 8 days in the dex amethasone group compared with 9 days in the control group without significant difference（P 0.05）.The serum CRP concentration on 4th day was lower in the dexamethasone group than that in the control group [（23.4±5.6）mmol/L vs.（41.3±6.2）mm ol/L,P0.05].The overall efficacy was higher in the dexamethasone group than that in the control group（88.7% vs.74.1%,P0.05）.The in-hospital mortal ity and incid ence of severe adverse events were not significantly different between the two gro ups（P0.05）.Conclusions Dexamethasone treatment is associated with a signific ant attenuation in systematic inflammatory response,but does not decrease mortality in hospitalized children with severe CAP.