糖皮质激素治疗感染性休克——对两项新英格兰医学杂志随机对照研究的分析

doi:10.3969/j.issn.1002-1949.2019.03.001

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摘要 2018年3月在新英格兰医学杂志（NEJM）上发表的两项大规模临床随机对照研究（ADRENAL研究及APROCCHSS研究），对糖皮质激素（glucocorticoid, Gc）在感染性休克患者的疗效进行了探索。其中ADRENAL研究结果显示，糖皮质激素不能改善90 d全因病死率，而APROCCHSS研究则与之相反，糖皮质激素使死亡的相对风险降低12%。不过，这两项研究结果均显示，糖皮质激素可缩短休克的持续时间，降低器官支持力度。采用包括基因、转录、炎症等“组学”技术，寻找从免疫调理治疗获益的脓毒症亚型是今后努力的方向。

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	周喆
	王立军

关键词 ：糖皮质激素（Gc）, 感染性休克, 随机对照研究, 新英格兰医学杂志(NEJM)

基金资助:广东省医学重点专科基金（2012-994）；广东省科技计划项目（2014A020212705）；深圳市科技计划项目（JCYJ201504022152005625）；深圳市宝安区医学重点专科基金（2012-01）；深圳市宝安区科技计划项目（2013005）

通讯作者: 王立军（1963-），男，博士，主任医师，教授，硕士生导师，E - mail：wanglj63@163.com。

作者简介: 周喆（1992-），男，硕士研究生，E-mail:zhou_zhe92@163.com。

引用本文:

周喆，王立军. 糖皮质激素治疗感染性休克——对两项新英格兰医学杂志随机对照研究的分析[J]. 中国急救医学, 2019, 39(3): 201-205.
Zhou Zhe, Wang Li-jun. Efficacy of hydrocortisone in the management of septic shock-insight into two randomized controlled trials published in New England Journal of Medicine. Chinese Journal of Critical Care Medicine, 2019, 39(3): 201-205.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2019.03.001 或 http://www.cnemergency.org.cn/CN/Y2019/V39/I3/201

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