\u2015\u6587\u732e\u540d\u2015<\/p>\n
\u2460Djillali Annane: Corticosteroids and pneumonia: time to change practice.The Lancet,Published online: January 18, 2015
\n\u2461Claudine Angela Blum: Adjunct prednisone therapy for patients with community-acquired pneumonia: a multicentre, double-blind, randomised, placebo-controlled trial.The Lancet,January 18, 2015<\/p>\n
\u2015\u8981\u7d04\u2015
\nBackground\uff1a
\n\u3000\u5168\u8eab\u6027\u30b9\u30c6\u30ed\u30a4\u30c9\u3092\u5e02\u4e2d\u80ba\u708e\u306e\u6cbb\u7642\u306b\u8ffd\u52a0\u3059\u308b\u3053\u3068\u306b\u3064\u3044\u3066\u306f\u3001\u672a\u3060\u8b70\u8ad6\u304c\u3042\u308b\u3002\u4eca\u56de\u5165\u9662\u5e02\u4e2d\u80ba\u708e\u306e\u60a3\u8005\u306b\u5bfe\u3057\u3001\u77ed\u671f\u30b9\u30c6\u30ed\u30a4\u30c9\u6cbb\u7642\u304c\u81e8\u5e8a\u7684\u5b89\u5b9a\u306b\u81f3\u308b\u307e\u3067\u306e\u671f\u9593\u3092\u77ed\u7e2e\u3059\u308b\u304b\u306e\u691c\u8a0e\u3092\u884c\u3063\u305f\u3002<\/p>\n
Methods\uff1a
\n\u3000\u3053\u306e\u4e8c\u91cd\u76f2\u691c\u591a\u65bd\u8a2d\u5171\u540c\u30e9\u30f3\u30c0\u30e0\u5316\u30d7\u30e9\u30bb\u30dc\u5bfe\u7167\u8a66\u9a13\u306b\u304a\u3044\u3066\u300118\u6b73\u4ee5\u4e0a\u306e\u652f\u67f1\u80ba\u708e\u306e\u60a3\u8005\u3092\u30b9\u30a4\u30b9\u306e7\u3064\u306e3\u6b21\u533b\u696d\u6a5f\u95a2\u304b\u3089\u767b\u9332\u3057\u305f\u3002\u60a3\u8005\u306f\u30e9\u30f3\u30c0\u30e0\u306b1\uff1a1\u306b\u30d7\u30ec\u30c9\u30cb\u30be\u30f3 50mg\/\u65e5\u3042\u308b\u3044\u306f\u30d7\u30e9\u30bb\u30dc\u30927\u65e5\u9593\u6295\u4e0e\u3059\u308b\u7fa4\u306b\u5272\u308a\u4ed8\u3051\u3089\u308c\u305f\u3002\u30d7\u30e9\u30a4\u30de\u30ea\u30a8\u30f3\u30c9\u30dd\u30a4\u30f3\u30c8\u3068\u3057\u3066\u81e8\u5e8a\u7684\u306a\u5b89\u5b9a\uff08\u30d0\u30a4\u30bf\u30eb\u30b5\u30a4\u30f3\u304c\u5c11\u306a\u304f\u3068\u308224\u6642\u9593\u5b89\u5b9a\uff09\u307e\u3067\u306e\u65e5\u6570\u3068\u3057\u305f\u3002<\/p>\n
Findings\uff1a
\n\u30002009\u5e7412\u67081\u65e5\u304b\u30892014\u5e745\u670821\u65e5\u307e\u3067\u306e\u9593\u30012911\u4eba\u306e\u60a3\u8005\u304c\u767b\u9332\u3055\u308c\u3001785\u4eba\u304c\u30e9\u30f3\u30c0\u30e0\u5316\u3055\u308c\u305f\u3002392\u4eba\u304c\u30d7\u30ec\u30c9\u30cb\u30be\u30f3\u7fa4\u3001393\u4eba\u304c\u30d7\u30e9\u30bb\u30dc\u7fa4\u3002\u81e8\u5e8a\u7684\u306b\u5b89\u5b9a\u3059\u308b\u307e\u3067\u306e\u671f\u9593\u306e\u4e2d\u592e\u5024\u306f\u30d7\u30ec\u30c9\u30cb\u30be\u30f3\u7fa4\u306e\u65b9\u304c\u6709\u610f\u306b\u306b\u77ed\u304b\u3063\u305f\uff08\u30d7\u30ec\u30c9\u30cb\u30be\u30f3\u7fa4\u30003.0 days, IQR 2.5-3.4\u3001\u30d7\u30e9\u30bb\u30dc\u7fa4\u30004.4 days, 4.0-5.0; hazard ratio[HR] 1.33, 95% CI 1.15-1.50, p<0.0001\uff09\uff08Table 2\uff09\u3002\n\u300030\u65e5\u76ee\u307e\u3067\u306e\u80ba\u708e\u95a2\u9023\u5408\u4f75\u75c7\u306b\u3064\u3044\u3066\u306f\u4e21\u7fa4\u3068\u3082\u5dee\u306f\u307f\u3089\u308c\u306a\u304b\u3063\u305f\uff0811 [3%] in the prednisone group and 22 [6%] in the placebo group; odds ratio [OR] 0.49 [95% CI 0.23-1.02]; p=0.056\uff09\uff08Table 3\uff09\u3002\n\u3000\u30d7\u30ec\u30c9\u30cb\u30be\u30f3\u7fa4\u306f\u30a4\u30f3\u30b9\u30ea\u30f3\u3092\u8981\u3059\u308b\u5165\u9662\u4e2d\u306e\u9ad8\u8840\u7cd6\u306e\u983b\u5ea6\u304c\u6709\u610f\u306b\u591a\u304b\u3063\u305f\uff08\u30d7\u30ec\u30c9\u30cb\u30be\u30f3\u7fa4 76 [19%] vs 43 [11%]; OR 1.96, 95% CI 1.31-2.93, p=0.0010\uff09\uff08Table 3\uff09\u3002\n\u3000\u30b9\u30c6\u30a4\u30ed\u30a4\u30c9\u306b\u3088\u308b\u305d\u306e\u4ed6\u306e\u6709\u5bb3\u4e8b\u8c61\u306f\u307e\u308c\u3067\u3042\u308a\u3001\u4e21\u7fa4\u3068\u3082\u5dee\u306f\u307f\u3089\u308c\u306a\u304b\u3063\u305f\uff08Table 3\uff09\u3002\n\nLimitation\uff1a\n\u3000\u5165\u9662\u60a3\u8005\u3068\u3057\u305f\u305f\u3081\u3001\u5916\u6765\u60a3\u8005\u5168\u4f53\u3078\u306e\u4e00\u822c\u5316\u306e\u9650\u754c\u3042\u308a\u3002\n\u3000\u6b7b\u4ea1\u6570\u304c\u5c11\u306a\u3044\u306e\u3067\u691c\u8a0e\u3059\u308b\u306b\u306f\u30d1\u30ef\u30fc\u4e0d\u8db3\u3002\n\u3000Primary endpoint\u306b\u304a\u3044\u3066\u3044\u304f\u3064\u304b\u306e\u30d1\u30e9\u30e1\u30fc\u30bf\u30fc\u304c\u5b58\u5728\u3057\u3066\u3044\u308b\u3053\u3068\u3002\u3057\u304b\u3057\u3001\u7b46\u8005\u3068\u3057\u3066\u306f\u3001\u3053\u308c\u306f\u73fe\u5b9f\u306b\u5373\u3057\u3066\u3044\u308b\u3068\u8003\u3048\u3066\u3044\u308b\u3002\n\nInterpretation\uff1a\n\u3000\u5165\u9662\u3092\u8981\u3059\u308b\u5e02\u4e2d\u80ba\u708e\u306e\u60a3\u8005\u306b\u5bfe\u3059\u308b7\u65e5\u9593\u306e\u30d7\u30ec\u30c9\u30cb\u30be\u30f3\u6cbb\u7642\u306f\u5408\u4f75\u75c7\u3092\u5897\u52a0\u3055\u305b\u308b\u3053\u3068\u306a\u304f\u81e8\u5e8a\u7684\u306a\u5b89\u5b9a\u307e\u3067\u306e\u671f\u9593\u3092\u77ed\u7e2e\u3059\u308b\u3002\u3053\u306e\u7d50\u679c\u306f\u60a3\u8005\u306e\u5229\u76ca\u3001\u533b\u7642\u306e\u8cbb\u7528\u3001\u52b9\u7387\u6027\u304b\u3089\u306f\u5207\u5b9f\u306a\u3082\u306e\u3067\u3042\u308b\u3068\u8a00\u3048\u308b\u3002\n\n\n\n\u3010\u958b\u50ac\u65e5\u3011\n2015\u5e743\u67084\u65e5(\u6c34)\n<\/p>\n","protected":false},"excerpt":{"rendered":"