Effects of glucocorticoid combined with antibiotic treatment on serological indices in patients with severe community-acquired pneumonia in high-altitude regions
10.3760/cma.j.cn341190-20250123-00128
- VernacularTitle:高原地区糖皮质激素联合抗生素治疗对重症社区获得性肺炎患者血清学指标的影响
- Author:
Haiye WAN
1
;
Meilang QUCUO
Author Information
1. 西藏大学医学院，拉萨 850000
- Publication Type:Journal Article
- Keywords:
Pneumonia;
Community-acquired infections;
Glucocorticoids;
Anti-bacterial agents;
Hemoglobins;
Lymphocyte count;
C-reactive protein
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(9):1304-1308
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effects of glucocorticoid combined with antibiotic treatment on serological infection indicators and other common hematological parameters in patients with severe community-acquired pneumonia in the Tibetan plateau region.Methods:This study adopted a retrospective design. Ninety-six patients with severe community-acquired pneumonia who were admitted to the Department of Respiratory and Critical Care Medicine, People's Hospital of Xizang Autonomous Region from February 2021 to February 2024 were included. The patients were grouped based on whether they received glucocorticosteroids during their hospitalization: those who received empirical broad-spectrum antibiotics early after admission were classified as the conventional treatment group ( n = 73), while those who were administered glucocorticosteroids in addition to conventional antibiotic treatment (including methylprednisolone, hydrocortisone, and prednisone) after admission formed the combined treatment group ( n = 23). The levels of serological indicators, including hemoglobin, total white blood cell count, neutrophil count, lymphocyte count, platelet count, C-reactive protein, procalcitonin, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, total bilirubin, creatinine, blood potassium, and blood sodium, were compared before and after treatment between the two groups. Results:The age of the combined treatment group was (67.17 ± 14.63) years, with 14 males, and the median hospitalization time was 15.0 (10.0, 23.0) days. The age of the conventional group was (67.66 ± 14.66) years, with 45 males, and the median hospitalization time was 13.0 (9.5, 13.5) days. In the combined treatment group, after treatment, hemoglobin ( t = 3.05, P < 0.001), C-reactive protein ( t = 3.61, P < 0.05), and platelet count ( Z = -2.43, P = 0.020) levels all decreased compared with pre-treatment levels, while lymphocyte count ( Z = -2.66, P = 0.010) and platelet count ( Z = -1.79, P = 0.070) increased compared with pre-treatment levels. In the conventional treatment group, after treatment, hemoglobin ( t = 6.09, P < 0.001), total white blood cell count ( Z = -4.51, P < 0.001), neutrophil count ( Z = -5.25, P < 0.001), C-reactive protein ( t = 7.45, P < 0.001), procalcitonin ( Z = -5.37, P < 0.001), alanine aminotransferase ( Z = -2.15, P = 0.03), creatinine ( Z = -5.38, P < 0.001), and blood urea nitrogen ( Z = -2.80, P = 0.010) levels all decreased compared with pre-treatment levels, while lymphocyte count ( Z = -4.84, P < 0.001) and platelet count ( Z = -4.51, P < 0.001) increased compared with pre-treatment levels. There were no statistically significant differences in any of the indicators between the two groups (all P > 0.05). Conclusions:In patients with severe community-acquired pneumonia in the Tibetan plateau region, the use of corticosteroids in addition to antibiotic treatment did not show considerable improvement in serum infection markers and other common hematological indicators.
