关键词: 糖皮质激素, 感染性休克, 氢化可的松

Abstract:

Role of glucocorticoids in the treatment of septic shock JI Xian-fei，LI Chun-sheng. Department of Emergency, Beijing Chaoyang Hospital Affiliated to Capital University of Medical Science, Beijing 100020, China Corresponding author: LI Chun-sheng，E-mail:lcscyyy@sohu.com Abstract The use of glucocorticoids in septic shock patients has been controversial for decades. High-dose glucocorticoids were standard therapy in the 1970s and 1980s. During the late 1980s, the consensus was that glucocorticoids should not be used in sepsis and septic shock after two studies with broad scale had not shown an improved survival, even had been harmful for patients treated with steroids. Studies in the late 1990s and early 2000s demonstrated the lower doses of glucocorticoids for longer periods would reverse shock and even improve survival. However, the recent CORTICUS study did demonstrate the lower doses of glucocorticoids increased incidence of superinfection including new sepsis or septic shock, but did not decrease 28-day mortality rate. It is noteworthy that the efficacy and safety of glucocorticoids in sepsis have been investigated in randomized controlled trials for half a century, and still, the treatment remains controversial.

Key words: glucocorticoids, septic shock, hydrocortisone