小剂量糖皮质激素治疗老年大叶性肺炎伴脓毒症的疗效分析

Efficacy of low dose glucocorticoids in the treatment of senile lobar pneumonia pneumonia complicated with sepsis

目的探讨小剂量糖皮质激素治疗老年大叶性肺炎伴脓毒症的疗效及不良反应。方法将2015年1月至2017年6月本院收治的大叶性肺炎伴脓毒症老年患者64例,随机分成观察组和对照组,各32例。对照组采用常规抗感染及对症治疗,观察组在此基础上应用甲泼尼龙琥珀酸钠1～2 mg/(kg·d)治疗,观察两组临床疗效、不良反应和治疗前、后血沉(ESR),血清降钙素原(PCT)白细胞介素-6(IL-6)、白细胞介素-8(IL-8)和超敏-C反应蛋白(hs-CRP)水平。结果治疗后观察组总有效率为87.50%显著高于对照组56.25%,观察组咳喘明显减轻时间、肺内啰音明显减轻时间、退热时间、胸片肺部阴影消失时间、住院时间均明显短于对照组;治疗后两组ESR,血清PCT、IL-6、IL-8和hs-CRP水平均显著降低(P<0.05),观察组ESR、PCT、IL-6、IL-8、hs-CRP水平显著低于对照组(P<0.05)。两组患者治疗期无不良反应。结论小剂量糖皮质激素可改善大叶性肺炎伴脓毒症患者临床症状,临床疗效显著,安全性较高。

Objective To investigate the efficacy and adverse effects of small dose corticosteroids in the treatment of senile lobar pneumonia and sepsis.Methods 64 elderly patients with lobar pneumonia and sepsis treated in our hospital in January 2015 in June 2017 were randomly divided into an observation group and a control group,with 32 cases in each group.The control group was treated with conventional anti infection and symptomatic treatment,The observation group was treated with methylprednisolone sodium succinate 1-2 mg/(kg·d)besides the treatment.clinical efficacy,and adverse reactions of the two groups before and after treatment,the erythrocyte sedimentation rate(ESR),serum procalcitonin(PCT)and interleukin-6(IL-6),interleukin-8(IL-8)and high sensitive-C reactive protein(hs-CRP)level.Results After treatment,the total efficiency of observation group was 87.50%higher than that of the control group of 56.25%children with asthma,significantly reduce the time and pulmonary rales significantly reduce the time and the time of fever,chest lung shadow disappear time and hospital stay were significantly shorter than the control group;the two groups after the treatment of erythrocyte sedimentation rate(ESR),serum procalcitonin(PCT)interleukin-6(IL-6),interleukin-8(IL-8)and high sensitive-C reactive protein(hs-CRP)levels were significantly lower(P<0.05),ESR,PCT,IL-6 in the observation group,IL-8 and hs-CRP were significantly lower than the control group(P<0.05).Conclusion There was no adverse reaction in the two groups during the treatment.Small dose glucocorticoid can improve the clinical symptoms of senile lobar pneumonia and sepsis.The clinical effect is significant and the safety is high.