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BMJ:新冠肺炎药物治疗的有效性研究

2020-08-01 MedSci原创 MedSci原创

与标准护理相比,糖皮质激素可能降低covid-19患者的死亡率和机械通气风险。大多数干预措施的有效性尚不确定

近日研究人员开展系统综述及荟萃分析考察了2019年冠状病毒病(covid-19)的治疗效果。
 
研究人员考察了美国疾病控制和预防中心涉及COVID-19研究数据库,其中包括25个电子数据库和6个中国数据库,截至日期为2020年7月20日。入选标准为随机临床试验,将疑似、可能或确诊的covid-19患者随机分为药物治疗组、标准护理组或安慰剂组。
 
总计23个随机对照试验纳入本次荟萃分析。由于存在偏倚和严重的数据不精确性,大多数证据的可信性非常低。与标准护理和机械通气相比,糖皮质激素是唯一有证据表明可减少患者死亡率的药物干预措施。与标准治疗相比,3种药物可能会缩短患者症状的持续时间,分别为羟氯喹(平均差异为-4.5天,低确定性)、瑞德西韦(-2.6天,中等确定性)和克力芝(洛匹那韦/利托那韦)(低确定性,-1.2天)。与其他干预措施相比,羟氯喹可能会增加不良事件的风险,而瑞德西韦导致停药的不良反应风险较低。
 
研究认为,与标准护理相比,糖皮质激素可能降低covid-19患者的死亡率和机械通气风险。大多数干预措施的有效性尚不确定。
 
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  1. [GetPortalCommentsPageByObjectIdResponse(id=908705, encodeId=325a908e056a, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201216/dbf12fd1b77d4b8e8da0aaf2b1a05175/5eabb5aa9ac84023939f2ffcbea948ba.jpg, createdBy=2fd95325345, createdName=小南姑娘, createdTime=Wed Dec 16 21:38:30 CST 2020, time=2020-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849071, encodeId=6a3018490e1e8, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Sun Jun 20 00:09:23 CST 2021, time=2021-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1028367, encodeId=03f7102836e71, content=新冠肺炎,疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Sat Aug 01 13:09:23 CST 2020, time=2020-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=805576, encodeId=7bb88055e622, content=根据危险等级的划分用药,合理。 中药大有用武之地。, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3a2c5173408, createdName=146dfd1em22暂无昵称, createdTime=Sat Aug 01 11:08:33 CST 2020, time=2020-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=805531, encodeId=b31c80553124, content=<a href='/topic/show?id=46ce580e865' target=_blank style='color:#2F92EE;'>#新冠肺炎#</a>其实各种治疗方法疗效均一般,而且还要看在轻症还是中重度患者中, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58078, encryptionId=46ce580e865, topicName=新冠肺炎)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Sat Aug 01 10:19:03 CST 2020, time=2020-08-01, status=1, ipAttribution=)]
    2020-12-16 小南姑娘

    学习

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=908705, encodeId=325a908e056a, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201216/dbf12fd1b77d4b8e8da0aaf2b1a05175/5eabb5aa9ac84023939f2ffcbea948ba.jpg, createdBy=2fd95325345, createdName=小南姑娘, createdTime=Wed Dec 16 21:38:30 CST 2020, time=2020-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849071, encodeId=6a3018490e1e8, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Sun Jun 20 00:09:23 CST 2021, time=2021-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1028367, encodeId=03f7102836e71, content=新冠肺炎,疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Sat Aug 01 13:09:23 CST 2020, time=2020-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=805576, encodeId=7bb88055e622, content=根据危险等级的划分用药,合理。 中药大有用武之地。, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3a2c5173408, createdName=146dfd1em22暂无昵称, createdTime=Sat Aug 01 11:08:33 CST 2020, time=2020-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=805531, encodeId=b31c80553124, content=<a href='/topic/show?id=46ce580e865' target=_blank style='color:#2F92EE;'>#新冠肺炎#</a>其实各种治疗方法疗效均一般,而且还要看在轻症还是中重度患者中, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58078, encryptionId=46ce580e865, topicName=新冠肺炎)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Sat Aug 01 10:19:03 CST 2020, time=2020-08-01, status=1, ipAttribution=)]
    2021-06-20 gaoxiaoe
  3. [GetPortalCommentsPageByObjectIdResponse(id=908705, encodeId=325a908e056a, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201216/dbf12fd1b77d4b8e8da0aaf2b1a05175/5eabb5aa9ac84023939f2ffcbea948ba.jpg, createdBy=2fd95325345, createdName=小南姑娘, createdTime=Wed Dec 16 21:38:30 CST 2020, time=2020-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849071, encodeId=6a3018490e1e8, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Sun Jun 20 00:09:23 CST 2021, time=2021-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1028367, encodeId=03f7102836e71, content=新冠肺炎,疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Sat Aug 01 13:09:23 CST 2020, time=2020-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=805576, encodeId=7bb88055e622, content=根据危险等级的划分用药,合理。 中药大有用武之地。, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3a2c5173408, createdName=146dfd1em22暂无昵称, createdTime=Sat Aug 01 11:08:33 CST 2020, time=2020-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=805531, encodeId=b31c80553124, content=<a href='/topic/show?id=46ce580e865' target=_blank style='color:#2F92EE;'>#新冠肺炎#</a>其实各种治疗方法疗效均一般,而且还要看在轻症还是中重度患者中, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58078, encryptionId=46ce580e865, topicName=新冠肺炎)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Sat Aug 01 10:19:03 CST 2020, time=2020-08-01, status=1, ipAttribution=)]
    2020-08-01 公卫新人

    新冠肺炎,疫情何时才能消失

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=908705, encodeId=325a908e056a, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201216/dbf12fd1b77d4b8e8da0aaf2b1a05175/5eabb5aa9ac84023939f2ffcbea948ba.jpg, createdBy=2fd95325345, createdName=小南姑娘, createdTime=Wed Dec 16 21:38:30 CST 2020, time=2020-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849071, encodeId=6a3018490e1e8, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Sun Jun 20 00:09:23 CST 2021, time=2021-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1028367, encodeId=03f7102836e71, content=新冠肺炎,疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Sat Aug 01 13:09:23 CST 2020, time=2020-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=805576, encodeId=7bb88055e622, content=根据危险等级的划分用药,合理。 中药大有用武之地。, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3a2c5173408, createdName=146dfd1em22暂无昵称, createdTime=Sat Aug 01 11:08:33 CST 2020, time=2020-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=805531, encodeId=b31c80553124, content=<a href='/topic/show?id=46ce580e865' target=_blank style='color:#2F92EE;'>#新冠肺炎#</a>其实各种治疗方法疗效均一般,而且还要看在轻症还是中重度患者中, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58078, encryptionId=46ce580e865, topicName=新冠肺炎)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Sat Aug 01 10:19:03 CST 2020, time=2020-08-01, status=1, ipAttribution=)]
    2020-08-01 146dfd1em22暂无昵称

    根据危险等级的划分用药,合理。 中药大有用武之地。

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=908705, encodeId=325a908e056a, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201216/dbf12fd1b77d4b8e8da0aaf2b1a05175/5eabb5aa9ac84023939f2ffcbea948ba.jpg, createdBy=2fd95325345, createdName=小南姑娘, createdTime=Wed Dec 16 21:38:30 CST 2020, time=2020-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849071, encodeId=6a3018490e1e8, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Sun Jun 20 00:09:23 CST 2021, time=2021-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1028367, encodeId=03f7102836e71, content=新冠肺炎,疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Sat Aug 01 13:09:23 CST 2020, time=2020-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=805576, encodeId=7bb88055e622, content=根据危险等级的划分用药,合理。 中药大有用武之地。, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3a2c5173408, createdName=146dfd1em22暂无昵称, createdTime=Sat Aug 01 11:08:33 CST 2020, time=2020-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=805531, encodeId=b31c80553124, content=<a href='/topic/show?id=46ce580e865' target=_blank style='color:#2F92EE;'>#新冠肺炎#</a>其实各种治疗方法疗效均一般,而且还要看在轻症还是中重度患者中, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58078, encryptionId=46ce580e865, topicName=新冠肺炎)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Sat Aug 01 10:19:03 CST 2020, time=2020-08-01, status=1, ipAttribution=)]
    2020-08-01 lovetcm

    #新冠肺炎#其实各种治疗方法疗效均一般,而且还要看在轻症还是中重度患者中

    0

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