| 孙敬婧.糖皮质激素辅助治疗社区获得性肺炎的研究进展[J].内科急危重症杂志,2026,32(5):484-489 |
| 糖皮质激素辅助治疗社区获得性肺炎的研究进展 |
| Recent advances in adjuvant corticosteroid treatment for community-acquired pneumonia |
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| DOI：10.11768/nkjwzzzz.202512291972 |
| 中文关键词: 社区获得性肺炎 糖皮质激素 辅助治疗 |
| 英文关键词: Community -acquired pneumonia Glucocorticoids Adjunctive therapy |
| 基金项目: |
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| 摘要点击次数: 7 |
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| 中文摘要: |
| 摘要 社区获得性肺炎（CAP）是住院与死亡的重要原因，部分患者尽管接受强有力的抗感染治疗，但仍因宿主炎症失衡而进展为急性呼吸窘迫综合征（ARDS）、脓毒性休克和多器官功能障碍。糖皮质激素可通过抑制促炎通路与改善血流动力学反应性而可能改善结局，但也可能增加高血糖与继发感染等风险，因此其在CAP中的应用存在争议。近年多项随机对照试验及系统评价更新了糖皮质激素辅助治疗sCAP的获益与风险证据，并推动相关指南的推荐策略调整。本文综述糖皮质激素在CAP中的作用机制、关键临床研究证据与指南推荐，重点讨论适用人群、给药时机与方案选择，为临床决策提供参考。 |
| 英文摘要: |
| Abstract Community-acquired pneumonia (CAP) is a major cause of hospitalization and mortality. Despite intensive antimicrobial therapy, some patients still progress due to dysregulated host inflammation to acute respiratory distress syndrome (ARDS), septic shock, and multiple organ dysfunction. Glucocorticoids may improve outcomes by suppressing pro-inflammatory pathways and enhancing hemodynamic responsiveness, but they may also increase risks such as hyperglycemia and secondary infections; therefore, their use has remained controversial for a long time. In recent years, multiple randomized controlled trials and systematic reviews have updated the evidence on the benefits and risks of adjunctive glucocorticoids in sCAP and have prompted changes in recommendation strategies in relevant guidelines. This article reviews the mechanisms of action of glucocorticoids in CAP, key clinical evidence, and guideline recommendations, with a focus on patient selection, timing of administration, and regimen choices, to inform clinical decision-making. |
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