糖皮质激素在新型冠状病毒肺炎重型患者治疗中的临床研究

目的 探讨糖皮质激素在新型冠状病毒肺炎（以下简称新冠肺炎，COVID-19）重型患者治疗中的作用。方法 选取2020年1月20日至2月20日在首都医科大学附属北京地坛医院感染性疾病诊疗中心住院应用糖皮质激素治疗的新冠肺炎重型患者3例，同时选取同期住院应用常规治疗的3例新冠肺炎重型患者作为对照。结果 与常规治疗组相比，糖皮质激素治疗组患者体温恢复正常的时间缩短（2.7±1.2）d vs（6.3±0.6）d，P<0.05]、氧合指数恢复（大于300 mm Hg，1 mmHg=0.133 kPa）快（4.6±2.1）d vs（10.6±3.1）d，P<0.05]、肺部影像学好转的时间缩短（4.3±1.5）d vs（7.6±1.2）d，P<0.05]。吸氧时间缩短（12.1±0.8）d vs（21.7±5.7）d，P<0.05]，临床症状缓解时间缩短（2.3±0.5）d vs（7.3±0.6）d，P<0.05]。结论 糖皮质激素对新冠肺炎重型患者临床症状缓解、氧合改善、肺部病变吸收有促进作用，在治疗过程中可以尝试早期小剂量短疗程使用。

Clinical research of glucocorticoid treatment in severe cases of COVID-19

Objective To evaluate the effect of glucocorticoid (GC) on severe cases of COVID-19. Methods There were 6 severe cases of diagnosed COVID-19 patients enrolled in Beijing Ditan Hospital during January 20th and February 20th in 2020.According to treatments,these patients were divided into two groups:GC group and control group. Results Compared with control group, the recovery of temperature(2.7±1.2) d vs (6.3±0.6) d, P<0.05],oxygenation index (more than 300 mmHg,1 mmHg=0.133 kPa)(4.6±2.1) d vs (10.6±3.1) d, P<0.05], pulmonary inflammation(4.3±1.5) d vs (7.6±1.2) d, P<0.05] and the clinical symptoms improvement(2.3±0.5) d vs (7.3±0.6) d, P<0.05] were earlier in GC group, and the time of oxygen inhalation was shortened(12.1±0.8) d vs (21.7±5.7) d, P<0.05]. Conclusion Earlier use of glucocorticoid with small doses could alleviate clinical symptoms, improve their clinical courses, and promote the absorbance of infiltration in their lungs manifested in chest computed tomography(CT)for the severe cases of COVID-19.