中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2014年
12期
756-759
,共4页
糖皮质激素%急性呼吸窘迫综合征%儿童
糖皮質激素%急性呼吸窘迫綜閤徵%兒童
당피질격소%급성호흡군박종합정%인동
Corticosteroid%Acute respiratory distress syndrome%Children
持久的全身和肺部炎症反应是急性呼吸窘迫综合征(acute respiratory distress syn-drome,ARDS)使用糖皮质激素(简称激素)治疗的基本依据,但目前ARDS患者使用激素的剂量、时间、疗程和效果仍然存在争议.大剂量、短疗程激素疗效欠佳,甚至增加病死率.现阶段认为相对中长疗程(2周～1个月)、小剂量或替代剂量(如甲泼尼龙1 ～2 mg/kg)激素,可降低ARDS病死率,缩短住ICU时间和呼吸机使用时间,并减轻肺纤维化.儿童ARDS的激素治疗仍缺少多中心、随机对照研究.
持久的全身和肺部炎癥反應是急性呼吸窘迫綜閤徵(acute respiratory distress syn-drome,ARDS)使用糖皮質激素(簡稱激素)治療的基本依據,但目前ARDS患者使用激素的劑量、時間、療程和效果仍然存在爭議.大劑量、短療程激素療效欠佳,甚至增加病死率.現階段認為相對中長療程(2週～1箇月)、小劑量或替代劑量(如甲潑尼龍1 ～2 mg/kg)激素,可降低ARDS病死率,縮短住ICU時間和呼吸機使用時間,併減輕肺纖維化.兒童ARDS的激素治療仍缺少多中心、隨機對照研究.
지구적전신화폐부염증반응시급성호흡군박종합정(acute respiratory distress syn-drome,ARDS)사용당피질격소(간칭격소)치료적기본의거,단목전ARDS환자사용격소적제량、시간、료정화효과잉연존재쟁의.대제량、단료정격소료효흠가,심지증가병사솔.현계단인위상대중장료정(2주～1개월)、소제량혹체대제량(여갑발니룡1 ～2 mg/kg)격소,가강저ARDS병사솔,축단주ICU시간화호흡궤사용시간,병감경폐섬유화.인동ARDS적격소치료잉결소다중심、수궤대조연구.
The presence and persistence of systemic and lung inflammation in children with acute respiratory distress syndrome (ARDS) is the basis for the use of corticosteroids as a therapeutic agent.The trial of ARDS treated with high-dose short-course corticosteroids showed no benefit,even increase motality.At present,the results of randomized controlled trial and meta-analysis suggested that low-dose and replacement-dose methylprednisolone [1-2 mg/(kg· d)] or equivalent types of corticosteroids may decrease the fatality rate,reduce staying days in ICU and the duration of mechanical ventilation.Use of corticosteroids for ARDS in children is still lack of multicenter randomized controlled trial.
