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目的探讨糖皮质激素在治疗艾滋病合并PCP中对氧合功能及短期预后的作用。方法回顾性分析2005～2008年艾滋病合并PCP病例58例,氧合指数作为糖皮质激素疗效的判别指标,采用方差分析分析糖皮质激素的疗效。结果58例中有43例(74.1%)使用糖皮质激素;所有患者经糖皮质激素治疗后氧合指数均有提高;糖皮质激素治疗后氧合指数在有糖皮质激素应用指征组和无指征组的升高幅度差异无统计学意义;糖皮质激素治疗前后氧合指数差值随治疗前氧合指数水平升高而下降。未出现糖皮质激素相关严重不良反应。结论在艾滋病合并PCP治疗中,适当应用糖皮质激素,对减轻患者肺部症状、改善氧合功能有一定疗效,特别是对于治疗前氧合指数水平较低者(氧合指数≤300mmHg)的肺功能改善更明显。
Objective To investigate the effect of glucocorticoids on oxygenation and short-term prognosis in the treatment of AIDS complicated with PCP. Methods A retrospective analysis of 58 cases of AIDS with PCP between 2005 and 2008, the oxygenation index as a discriminant indicator of glucocorticoid efficacy, analysis of variance using the efficacy of glucocorticoid. Results Of the 58 cases, 43 cases (74.1%) used glucocorticoid; all patients had higher oxygenation index after glucocorticoid treatment; oxygenation index after glucocorticoid treatment showed glucocorticoid application and no There was no significant difference in the increase rate of the index group before and after glucocorticoid treatment. The difference of oxygenation index decreased with the increase of oxygenation index before treatment. No glucocorticoid-related serious adverse reactions occurred. Conclusion Appropriate glucocorticoids in the treatment of AIDS complicated with PCP have a certain effect on alleviating lung symptoms and improving oxygenation function in patients, especially for those with lower oxygenation index (oxygenation index ≤300mmHg) before treatment Function improvement is more obvious.