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首页> 外文期刊>Renal failure. >Moderate-dose glucocorticoids as salvage therapy for severe pneumonia in renal transplant recipients: A single-center feasibility study
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Moderate-dose glucocorticoids as salvage therapy for severe pneumonia in renal transplant recipients: A single-center feasibility study

机译：中剂量糖皮质激素作为肾移植受者重症肺炎的挽救疗法：单中心可行性研究

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This study aimed to assess the effectiveness and safety of moderate-dose glucocorticoids (GCs) with mechanical ventilation as salvage therapy for renal transplant recipients with severe pneumonia, which was non-responsive to conventional treatment. A retrospective study was conducted involving renal transplant recipients diagnosed with severe pneumonia and did not respond to conventional treatment. All immunosuppressants were then completely withdrawn, and the patients were initially administered with methylprednisolone at doses of 2.0-2.5mg/kg/day once every 12h. This dosage was continued until oxygenation improved, and the treatment was gradually tapered (by 20mg every 2-3 days) to the previous maintenance dosage. Ten patients were recruited from year 2008 to 2012. Two patients who underwent emergency endotracheal intubation were intubated on days 3 and 8, respectively, another one died from recurrent pneumothorax. The mean PaO2/FiO2 of the nine survivors was significantly increased by the increasing treatment duration; whereas the lung injury scores (LIS) and the sequential organ failure assessment (SOFA) score were both significantly decreased. The use of moderate-dose GCs may play a role as salvage therapy for renal transplant recipients with severe pneumonia. However, further study with larger trials to is needed.
机译：这项研究旨在评估中剂量糖皮质激素（GCs）的机械通气作为对严重肺炎的肾移植接受者的挽救疗法的有效性和安全性，该疗法对常规治疗无反应。进行了一项回顾性研究，涉及被诊断患有严重肺炎且对常规治疗无反应的肾移植受者。然后将所有的免疫抑制剂完全撤除，开始时每12h给患者服用甲基泼尼松龙，剂量为2.0-2.5mg / kg /天。继续该剂量直至氧合作用改善，并且治疗逐渐缩小（每2-3天减少20mg）至先前的维持剂量。从2008年至2012年招募了10名患者。分别在第3天和第8天对2例接受了紧急气管插管的患者进行了插管，另一例死于复发性气胸。随着治疗时间的延长，九名幸存者的平均PaO2 / FiO2显着增加。而肺损伤评分（LIS）和器官功能衰竭评估（SOFA）评分均显着降低。对于患有严重肺炎的肾移植受者，使用中等剂量的气相色谱可能起挽救作用。但是，需要对更大的试验进行进一步的研究。

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