甲强龙治疗重症社区获得性肺炎的疗效及对血清C反应蛋白.docVIP

甲强龙治疗重症社区获得性肺炎的疗效及对血清C反应蛋白水平的影响 班健 广西钦州市中医医院呼吸内科，535000 [摘要]目的 探讨甲强龙治疗重症社区获得性肺炎(SCAP)的疗效及对血清C反应蛋白（CRP）水平的影响，以为临床SCAP治疗方案的选择提供一定的依据。方法 选择我院呼吸科于2017年1月-2018年3月期间收治的44例SCAP患者为研究对象，根据随机数字表法分为观察组与对照组，每组22例，对照组患者予常规抗感染治疗，观察组联合应用甲强龙治疗，疗程为7d。比较两组患者动脉血氧分压（PaO2）升高10mmHg时间、体温正常时间、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PaO2升高10mmHg、体温正常时间分别为（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%，差异有统计学意义（P＜0.05）；两组患者间住院时间、病死率比较，差异无统计学意义（P＞0.05）；治疗后，观察组血清CRP水平为（31.45±18.72）mg/L，明显低于对照组（51.24±20.53）mg/L，差异均有统计学意义（P＜0.05）。结论 甲强龙应用于重症社区获得性肺炎的治疗，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 Effect of methylprednisolone on severe community acquired pneumonia and its effect on serum C reactive protein Ban Jian Department of respiratory medicine, Qinzhou Municipal Hospital of traditional Chinese medicine, Guangxi, 535000 [Abstract] Objective To investigate the effect of methylprednisolone in the treatment of severe community acquired pneumonia (SCAP) and the effect on the level of serum C reactive protein (CRP) ,in order to provide a basis for the clinical therapy selection of SCAP. Methods 44 patients with SCAP in the Department of respiration of our hospital from January 2017 - March 2018 were selected and divided into the observation group and the control group, each group with 22 cases. The patients in control group were treated with routine anti infection treatment. The observation group combined with the treatment of methylprednisolone ,and the treatment course was 7 days. The two groups of patients were compared with arterial oxygen pressure (PaO2) rise 10mmHg time, normal time of body temperature, time of hospitalization and the incidence of double infection and mortality. The serum levels of CRP were measured before and after treatment. Results The PaO2 increased 10mmHg and normal temperature in the observation group were（4.81±1.48）d,（3.39±0.88）d respectively, which were significantly shorter than th