糖皮质激素对成人急性呼吸窘迫综合征患者预后影响的Meta分析

林艺延; 邓医宇

doi:10.14188/j.1671-8852.2024.0499

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糖皮质激素对成人急性呼吸窘迫综合征患者预后影响的Meta分析

急性呼吸窘迫综合征专题研究 | 更新时间：2026-11-05

- 糖皮质激素对成人急性呼吸窘迫综合征患者预后影响的Meta分析
- Meta⁃analysis of the effect of glucocorticoids on the prognosis of adult patients with acute respiratory distress syndrome
- 武汉大学学报（医学版） 2025年46卷第2期页码：199-204
- 作者机构：
  
  南方医科大学附属广东省人民医院/广东省医学科学院重症医学科广东广州 510080
- 作者简介：
  
  林艺延，男，1997—，医学硕士，主要从事ARDS研究，E⁃mail：linyiyan1997@163.com
  邓医宇，男，1972—，主任医师，主要从事脓毒症脑病与ARDS临床及机制研究，E⁃mail：yiyudeng666@163.com
- 基金信息：
  
  国家重点研发计划子课题(2021YFC2501802)
- DOI：10.14188/j.1671-8852.2024.0499
  中图分类号： R563.8
- 收稿：2024-07-04，
  
  纸质出版：2025-02-25
- 稿件说明：
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林艺延,邓医宇.糖皮质激素对成人急性呼吸窘迫综合征患者预后影响的Meta分析[J].武汉大学学报（医学版）,2025,46(02):199-204.

LIN Yiyan,DENG Yiyu.Meta⁃analysis of the effect of glucocorticoids on the prognosis of adult patients with acute respiratory distress syndrome[J].Medical Journal of Wuhan University,2025,46(02):199-204.
林艺延,邓医宇.糖皮质激素对成人急性呼吸窘迫综合征患者预后影响的Meta分析[J].武汉大学学报（医学版）,2025,46(02):199-204. DOI： 10.14188/j.1671-8852.2024.0499.

LIN Yiyan,DENG Yiyu.Meta⁃analysis of the effect of glucocorticoids on the prognosis of adult patients with acute respiratory distress syndrome[J].Medical Journal of Wuhan University,2025,46(02):199-204. DOI： 10.14188/j.1671-8852.2024.0499.

摘要

目的

采用Meta分析探讨糖皮质激素对成人急性呼吸窘迫综合征（ARDS）患者预后的影响。

方法

通过计算机检索PubMed、Embase、Cochrane Central Register of Controlled Trials数据库中与糖皮质激素治疗ARDS相关的随机对照试验（RCT）。检索时间段为各数据库最初时间至2024年6月1日。由2名研究者对检索结果进行整理、筛选及文献质量评价。采用Review Manager 5.4和R 4.3.2软件进行Meta分析。

结果

共纳入8篇文献，涉及1 372例ARDS患者，其中糖皮质激素组720例，对照组652例。与对照组相比，糖皮质激素组28 d全因死亡率风险无显著差异（

=0.87

95%

:0.73~1.04

0.05）；60 d全因死亡率显著降低（

=0.77

95%

:0.61~0.97

0.05）；28 d无呼吸机天数显著增加（

=4.51

95%

:3.37~5.66

0.001）；ICU全因死亡率显著降低（

=0.55

95%

:0.40~0.76

0.01）；住院全因死亡率显著降低（

=0.52

95%

:0.33~0.81

0.01）。

结论

糖皮质激素治疗能降低ARDS患者60 d全因死亡率、增加28 d无呼吸机天数、降低ICU全因死亡率和住院全因死亡率，但糖皮质激素治疗对ARDS患者的28 d全因死亡率无显著影响。

Abstract

Objective

To conduct a meta⁃analysis to investigate the effects of glucocorticoids on the prognosis of adult patients with acute respiratory distress syndrome (ARDS).

Methods

A comprehensive search was performed in PubMed

Embase

and the Cochrane Central Register of Controlled Trials to identify randomized controlled trials (RCTs) related to glucocorticoid treatment for ARDS. The search covered studies from the inception of each database to June 1

2024. Two researchers independently screened and selected the studies and assessed their quality. Meta⁃analysis was conducted using Review Manager 5.4 and R 4.3.2 software.

Results

Eight studies involving 1 372 ARDS patients were included

with 720 in the glucocorticoid group and 652 in the control group. Meta⁃analysis results indicated no significant difference in the risk of 28⁃day all⁃cause mortality between the glucocorticoid group and the control group (

=0.87

95%

: 0.73⁃1.04

0.05). However

60⁃day all⁃cause mortality was significantly reduced (

=0.77

95%

: 0.61⁃0.97

0.05). Additionally

the glucocorticoid group had significantly more ventilator⁃free days at 28 d (

=4.51 days

95%

: 3.37⁃5.66

0.001)

a significantly lower ICU all⁃cause mortality rate (

=0.55

95%

: 0.40⁃0.76

0.01)

and a significantly lower in⁃hospital all⁃cause mortality rate (

=0.52

95%

: 0.33⁃0.81

0.01).

Conclusion

Glucocorticoids demonstrate certain prognostic benefits in the treatment of ARDS patients

particularly in reducing 60⁃day all⁃cause mortality

increasing the number of ventilator⁃free days at 28 d

and lowering ICU and in⁃hospital all⁃cause mortality rates. However

glucocorticoids do not significantly affect 28⁃day all⁃cause mortality.

关键词

Keywords

references

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