BACKGROUND Enhancing awareness and use of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) is vital to curb human immunodeficiency virus (HIV) spread. High-risk behaviors prevalent among sexually transmitted infection clinic outpatients underscore the need for increased PrEP/PEP education in this group. AIM To investigate the effects of both onsite and online health education on the knowledge of, and willingness to use, PrEP and PEP among individuals receiving PEP services. METHODS Participants were drawn from a cohort study on PEP service intervention at an STD/AIDS outpatient clinic in designated HIV/AIDS hospitals in Beijing, conducted from January 1 to June 30, 2022. Health education was provided both onsite and online during follow-up. Surveys assessing knowledge of, and willingness to use, PrEP/PEP were administered at baseline and again at 24 wk post-intervention. RESULTS A total of 112 participants were enrolled in the study; 105 completed the follow-up at week 24. The percentage of participants with adequate knowledge of, and willingness to use, PrEP significantly increased from 65.2% and 69.6% at baseline to 83.8% and 82.9% at the end of the intervention (both P < 0.05). Similarly, those with adequate knowledge of, and willingness to use, PEP increased from 74.1% and 77.7% at baseline to 92.4% and 89.5% at week 24 (P < 0.05). Being between 31 years and 40 years of age, having a postgraduate degree or higher, and reporting a monthly expenditure of RMB 5000 or more were found to be significantly associated with knowledge of PrEP and PEP (both P < 0.05). CONCLUSION The findings show that both onsite and online health education significantly improved the knowledge of, and increased willingness to use, PrEP and PEP in individuals utilizing PEP services.

What is already known about this topic?:The prevalence of monkeypox (mpox) infections is primarily observed among young men who engage in sexual activities with other men, and there is a possibility of sexual transmission. Co-occurring sexually transmitted infections have also been documented.What is added by this report?:In this report, we present a case of a patient in China who was simultaneously diagnosed with mpox, and acute human immunodeficiency virus (HIV) infection. The patient exhibited symptoms of fever and widespread papules on the trunk, face, and genital area.What are the implications for public health practice?:It is crucial for health agencies to prioritize HIV testing when mpox is suspected or diagnosed in individuals with recent engagement in high-risk sexual behavior.

PurposeOngoing Monkeypox (MPX) outbreaks in countries outside Africa have unique characteristics. However, data on cohorts of confirmed cases in China is limited. The study provides important epidemiological, diagnostic, and clinical information about this disease in China.MethodsWe report a series of Chinese individuals with confirmed MPX infections identified at Beijing Youan Hospital (China) from June 10 to July 15, 2023. Samples were taken from the skin, anus, throat, and blood. An epidemiological questionnaire was used to collect demographic and clinical data. Further, we compared the MPX viral (MPXV) loads across different anatomical sites.Results66 samples were collected from 20 patients, all of whom were cisgender men. Median patient age was 29 years. Notably, 19 (95%) patients reported unprotected sexual encounters with men in the preceding month, and 13 (65%) were human immunodeficiency virus (HIV)-positive. Among those with HIV, 12 (92%) were receiving antiretroviral therapy, and 11 (85%) had well-controlled infections (HIV viral load <40/mL). The median CD4+ T cell count was 667 cells/mm3. In the HIV-negative group, three (43%) patients were taking preexposure prophylaxis. Fifteen patients (75%) had concurrent sexually transmitted infections (50% had syphilis and 65% had HIV) and eight (40%) had HIV and syphilis co-infection. MPXV loads were significantly higher in samples from the skin (cycle threshold value [Ct value]: 19·0) and anus (Ct value: 23.0) compared to samples from the throat (Ct value: 31.0) or blood (Ct value: 34.5). All patients had skin lesions (85% of whom presented with anogenital lesions). Common systemic symptoms included fever (85%) and lymphadenopathy (55%). The median incubation period was 8 d [interquartile range (IQR): 6–16 d]. The median time from the onset of skin lesions to scab removal was 14 d (IQR: 10–16 d). No deaths or severe cases were reported.ConclusionMPXV primarily affects young homosexual men. The high MPXV viral loads in skin and anal lesions indicate that transmission most likely occurs through direct and close body contact. This study also reports high rates of HIV and syphilis co-infection. Therefore, preventive efforts should focus on homosexual men.

Mpox is a zoonotic infectious disease caused by the mpox virus (MPXV). Historically, the majority of mpox cases have been documented in Central Africa. However, since May 2022, there has been a notable rise in reported cases from regions beyond Africa. Currently, over 110 countries spanning Europe, North America, South America, Asia, and other territories have reported mpox infections. This report details a case involving a patient who identifies as a man who has sex with men (MSM) and is concurrently infected with MPXV, human immunodeficiency virus type 1 (HIV-1), Pneumocystis jiroveci, as well as extensively drug-resistant tuberculosis (XDR-TB). This patient had also received a vaccination for smallpox in the past. Additionally, we provide photographic documentation charting the progression of dermatological manifestations associated with mpox. This case highlights the significance of sexual intercourse as a crucial mode of transmission for mpox. The rapid and widespread dissemination of the MPXV across various regions, especially among MSM communities, underscores the importance of enhancing preventive education efforts targeted at high-risk populations.

BackgroundVitamin D deficiency (VDD) is a worldwide disease. VDD is also associated with an increased risk of HIV-related comorbidities and mortality, and patients have a tendency to develop active tuberculosis compared to those with latent tuberculosis infection. Vitamin D supplementation may modulate HIV replication, improve TB inflammation and reduce progression of HIV-TB co-infection.MethodsWe meta-analyzed individual participant data from cohort studies, cross-sectional study, and RCTs of vitamin D in HIV group, TB group, and HIV-TB group. The primary outcomes were differences in vitamin D level and VDD prevalence between three groups, the secondary outcomes were CD4 count, HIV viral load, time to sputum smear conversion, time to culture conversion, relapse, morality, and TB score.ResultsFor vitamin D levels, the overall mean difference (MD) between HIV group and TB group was −0.21 (95% CI, −20.80–20.38; p = 0.9, I2 = 84%), HIV group and HIV-TB group was 0.87 (95% CI, −11.45–13.20; p = 0.89, I2 = 87%), and TB group and HIV-TB group was 1.17 (95% CI, −5.21–7.55; p = 0.72, I2 = 85%). For vitamin D deficiency prevalence, the overall odds ratio (OR) for HIV group versus TB group was 1.23 (95% CI, 0.46–3.31; p = 0.68; I2 = 70%), HIV group versus HIV-TB group was 1.53 (95% CI, 1.03–2.29; p = 0.04; I2 = 0%), and TB group versus HIV-TB group was 0.85 (95% CI, 0.61–1.20; p = 0.36; I2 = 22%). In HIV-TB group, the overall OR for vitamin D group versus placebo group was 0.78 (95% CI, 0.34–1.67; p = 0.52; I2 = 60%).ConclusionOur findings indicated that there were no variations in vitamin D levels between three groups. The prevalence of vitamin D deficiency was higher in the HIV-TB group than in the HIV group. Additionally, the administration of vitamin D supplements did not have obvious impact on CD4 count and viral load. Likewise, vitamin D had no effect on time to sputum smear conversion, time to culture conversion, relapse, 12-month morality, and TB score.

Tuberculous meningitis (TBM) emerges as a grave complication of tuberculosis in people living with HIV (PLWH). The diagnosis and treatment of TBM pose significant challenges, leading to elevated mortality rates. To comprehensively grasp the epidemiological landscape of TBM in PLWH, a systematic review and meta-analysis were meticulously undertaken. We performed a comprehensive search in PubMed, Embase, and Web of Science from database inception to September 19th, 2023, with no limitations on the publication type. The search terms were HIV/AIDS terms (AIDS OR HIV OR PLWH) and TBM-related terms (tuberculous meningitis OR TBM). Studies included in this meta-analysis evaluated the incidence of TBM among PLWH, or we were able to calculate the incidence of TBM among PLWH from the research. The analysis revealed that the prevalence of TBM among PLWH was 13.6

Introduction:Pulmonary tuberculosis (PTB) remains a significant health concern, particularly in individuals infected with human immunodeficiency virus (HIV) who are more susceptible to developing active TB disease. Early and accurate diagnosis of TB is crucial for effective treatment and prevention of transmission. This study aims to evaluate the potential of matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOFMS) analysis of bronchoalveolar lavage fluid (BALF) for diagnosis of suspected PTB in HIV-infected patients. Methods:This retrospective study recruited 60 HIV-infected patients with suspected PTB presenting with respiratory symptoms and abnormal chest radiographs between January 2022 and June 2023. BALF samples were collected and subjected to analysis using MALDI-TOF MS, GeneXpert, acid-fast bacilli (AFB) smear and culture. And their diagnostic performance was compared. Results:The sensitivity of MALDI⁃TOFMS for diagnosing PTB was 83.3 %, which was better than that of smear 11.9 %, culture 40.5 % or Xpert38.1 % (all p < 0.01). The area under the curve (AUC) value of MALDI⁃TOFMS was 0.889, which was better than that of smear 0.532, culture 0.675 or Xpert 0.690 (all p < 0.01). The katG315 and rpoB-RRDR 511 mutations were detected by the MALDI⁃TOFMS in two patients. Conclusion:Nucleotide MALDI-TOFMS has a good clinical performance for rapid diagnosis of PTB from BALF samples in HIV infected patients, and detects mutations of TB simultaneously.

Background and aims: Potassium-Competitive Acid Blockers (P-CABs) have been used in Helicobacter pylori (H. pylori) eradication therapies in recent years. However, the efficacy and safety of P-CABs compared to Proton -Pump Inhibitors (PPIs) in this setting remain controversial. Methods: The efficacy and safety of P-CABs and PPIs for H. pylori eradication were compared in a meta-analysis based on a systematic literature search of major electronic databases for relevant Randomized Controlled Trials (RCTs). Results: Seven studies and 1,168 patients were included. The pooled eradication rate determined by Intention-To -Treat (ITT) analysis was 90.2% for P-CAB-based and 75.5% for PPI-based triple therapy (pooled RR [95% CI] = 1.17 [1.08-1.28], p < 0.001). The Per-Protocol (PP) analysis also demonstrated significant superior-ity of P-CABs (pooled eradication rate = 92.4% vs. 77.8%; pooled RR [95% CI] = 1.14 [1.03-1.26], p < 0.01). In a subgroup evaluation, P-CABs were significantly better than PPIs as a first-line eradication therapy, in both the ITT analysis (pooled eradication rate = 91.8% vs. 76.4%; pooled RR [95% CI] = 1.18 [1.10-1.28], p < 0.0001) and the PP analysis (pooled eradication rate = 93.0% vs. 78.6%; pooled RR [95% CI] = 1.13 [1.02 - 1.26], p < 0.05). However, P-CABs were not superior to PPIs when administered as salvage therapy, as deter-mined in the ITT (75.0% vs. 66.0%, pooled RR [95% CI] = 1.11 [0.69-1.78], p = 0.66) and PP (85.7% vs. 70.0%, pooled RR [95% CI] = 1.20 [0.82-1.75], p = 0.34) analyses. In a subgroup analysis limited to Japanese patients, both the ITT analysis (pooled eradication rate = 89.6% vs. 73.9%; RR [95% CI] = 1.21 [1.14 - 1.29], p < 0.01) and the PP analysis (pooled eradication rate = 92.0% vs. 75.7%; RR [95% CI] = 1.18 [1.06 - 1.32], p < 0.01) showed that P-CABs were significantly superior compared to PPIs as triple eradication therapy. However, in the subgroup analysis of patients from other countries, there was no significant difference in either the ITT analysis (pooled eradication rate = 93.8% vs. 85.2%; RR [95% CI] = 1.10 [0.99-1.22], p = 0.07) or PP analysis (pooled eradication rate = 95.0% vs. 90.8%; RR [95% CI] = 1.05 [0.98-1.14], p = 0.17). The incidence of adverse events associated with the two regimens did not significantly differ (P-CABs vs. PPIs: 33.6% vs. 40.0%; RR [95% CI] = 0.84 [0.71???1.00], p = 0.05). The incidence of serious adverse events and dropout rate due to adverse events also did not differ (p = 0.44 and p = 0.67, respectively). Conclusions: The efficacy of P-CAB-based triple therapy is superior to that of PPI-based triple therapy as a first-line approach to H. pylori eradication, particularly in Japanese patients. As salvage therapy, the efficacy of the two treatments did not significantly differ. The tolerability of P-CAB-based and PPI-based triple therapy was compara-ble, as was the incidence of adverse events.

目的 探讨氢呼气试验在功能性肠病(FBD)患者小肠细菌过度生长情况分析中的应用.方法 分析2018年1月至2020年6月首都医科大学宣武医院消化科收治的1 224例FBD患者和175例健康志愿者的临床资料,按罗马Ⅳ诊断标准分为功能性便秘(574例)、功能性腹胀(272例)、功能性腹泻(62例)及肠易激综合征组(316例),所有纳入研究的患者和健康志愿者已行乳果糖氢呼气试验,分析检查结果.结果 FBD各亚型在小肠细菌过增长(SIBO)阳性率、OCTT延长发生率、回肠反流发生率均高于正常对照组(P＜0.05).功能性便秘组OCTT延长发生率明显高于其他亚型(P＜0.05);功能性便秘组OCTT时间明显高于其他亚型(P＜0.05),该组SIBO阳性患者OCTT时间明显长于SIBO阴性患者;功能性腹泻组OCTT时间明显短于其他亚型,该组SIBO阳性患者OCTT时间明显短于SIBO阴性患者.结论 SIBO与FBD密切相关,明确诊断SIBO可有助于FBD的治疗.各亚型FBD肠道传输时间有不同的表现,LBT可以较准确的反映功能性肠病患者存在的动力情况.氢呼气试验作为一种无创检测方法,可广泛应用于FBD的诊断.

目的 探讨原发性胃肠道淋巴瘤(PGIL)的临床、内镜及组织病理学特点,以提高其诊治水平.方法 回顾性分析2008年1月-2019年12月该院经内镜或手术活组织病理检查确诊的41例PGIL患者的临床、内镜及组织病理学特点.结果 病变部位依次为胃(73.2％)、小肠(12.2％)、结肠(9.8％)和直肠(4.8％).患者临床表现无特异性,主要症状为腹痛、腹胀、食欲减退和消瘦等.最常见的病理类型为弥漫性大B细胞淋巴瘤(DLBCL)(61.0％),其次为黏膜相关淋巴组织(MALT)淋巴瘤(34.2％).胃淋巴瘤肉眼形态以溃决型最多(36.7％),其次为隆起型、表层型和溃疡型等;小肠淋巴瘤肉眼形态以溃疡型最多(60.0％),其次为隆起型和多发性淋巴瘤性息肉病(MLP)型;大肠淋巴瘤肉眼形态以隆起型最多(83.3％).结论 PGIL好发于老年患者,女性略多于男性,临床表现缺乏特异性,腹痛和腹胀为最常见症状.内镜下病灶形态多样,肉眼形态和病变部位与病理类型相关.其中,DLBCL为最常见的病理类型.

目的 探讨并分析食管皮脂腺异位的临床、内镜、病理和预后等特点及该病内镜检出率.方法 收集2014年1月至2019年12月于首都医科大学宣武医院行上消化道内镜检查确诊为食管皮脂腺异位的病例,分析该病内镜检出率.结合相关文献回顾性分析总结83例食管皮脂腺异位患者的临床、内镜、病理及预后等特点.结果 食管皮脂腺异位好发于中年男性,年龄(52.4±12.6)岁,内镜检出率为0.00738％.内镜下多为黄色、扁平斑块状隆起,表面白色针尖状突起为其特征性表现.组织病理学可见表面被覆鳞状上皮的皮脂腺结构.该病属良性疾病,无需内镜下治疗,预后良好.结论 食管皮脂腺异位少见,内镜下易误诊为真菌性食管炎、食管黄斑瘤、食管癌及黏膜下肿瘤等,内镜医师应提高对该病的认识,避免误诊及不必要的治疗.该病组织学起源尚不清楚,推测可能为食管鳞状上皮或固有腺体化生.

目的 探讨综合护理干预措施对767例住院结肠镜检查患者肠道准备质量的影响,为提高结肠镜检查的肠道准备质量提供参考依据.方法 选择某院住院行结肠镜检查患者2018年3月1日-2018年7月31日387例作为对照组,给予常规肠道准备.2018年8月1日-2018年12月31日住院行结肠镜检查患者380例作为观察组,给予综合护理干预措施,比较2组患者肠道准备过程中不良反应发生率、肠道准备合格率.结果 给予综合护理干预措施后,观察组患者肠道准备过程中不良反应发生率为15.8%,较对照组的31.0%下降 15.2%,差异有统计学意义(P＜0.001).肠道准备清洁度合格率比对照组明显提高,由 62.2%提高到 85.3%,差异有统计学意义(P＜0.001).结论 给予结肠镜检查患者综合干预措施可显著降低患者肠道准备过程中不良反应发生率,明显提高结肠镜检查患者肠道准备合格率,最终提高医疗和护理工作质量.

BACKGROUND Constipation is one of the most important nonmotor symptoms in Parkinson's disease (PD) patients, and constipation of different severities is closely related to the pathogenesis of PD. PD with constipation (PDC) is considered a unique type of constipation, but its mechanism of formation and factors affecting its severity have been less reported. Understanding the gastrointestinal motility characteristics and constipation classification of PDC patients is essential to guide the treatment of PDC. In this study, the colonic transit test and high-resolution anorectal manometry were used to identify the intestinal motility of PDC to provide a basis for the treatment of PDC. AIM To investigate the clinical classification of PDC, to clarify its characteristics of colonic motility and rectal anal canal pressure, and to provide a basis for further research on the pathogenesis of PDC. METHODS Twenty PDC patients and 20 patients with functional constipation (FC) who were treated at Xuanwu Hospital of Capital Medical University from August 6, 2018 to December 2, 2019 were included. A colonic transit test and high-resolution anorectal manometry were performed to compare the differences in colonic transit time, rectal anal canal pressure, and constipation classification between the two groups. RESULTS There were no statistically significant differences in sex, age, body mass index, or duration of constipation between the two groups. It was found that more patients in the PDC group exhibited difficulty in defecating than in the FC group, and the difference was statistically significant. The rectal resting pressure, anal sphincter resting pressure, intrarectal pressure, and anal relaxation rate in the PDC group were significantly lower than those in the FC group. The proportion of paradoxical contractions in the PDC group was significantly higher than that in the FC group. There was a statistically significant difference in the type composition ratio of defecatory disorders between the two groups (P < 0.05). The left colonic transit time, rectosigmoid colonic transit time (RSCTT), and total colonic transit time were prolonged in PDC and FC patients compared to normal values. The patients with FC had a significantly longer right colonic transit time and a significantly shorter RSCTT than patients with PDC (P < 0.05). Mixed constipation predominated in PDC patients and FC patients, and no significant difference was observed. CONCLUSION Patients with PDC and FC have severe functional dysmotility of the colon and rectum, but there are certain differences in segmental colonic transit time and rectal anal canal pressure between the two groups.

目的 探讨中老年急性胰腺炎(AP)患者的临床特点.方法 回顾性分析2017年2月至2018年1月首都医科大学宣武医院收治的95例AP患者的临床资料,按照年龄将其分为青年组(48例)和中老年组(47例).分析比较2组患者的病因、临床表现、合并疾病以及AP并发症和病情严重程度分级.结果 中老年AP患者的主要病因是胆道疾病,比例高于青年组[55.3％(26/47)比6.2％(3/48)],差异有统计学意义(P＜0.05).2组患者的临床症状、体征比较差异均无统计学意义(均P ＞ 0.05).中老年患者合并糖尿病、高血压、冠心病(冠状动脉粥样硬化性心脏病)比例较高[27.7％(13/47)比8.3％(4/48)、23.4％(11/47)比6.2％(3/48)、21.3％(10/47)比4.2％(2/48)],差异均有统计学意义(均P ＜0.05).中老年患者AP病程中呼吸衰竭发生率明显高于青年组,差异有统计学意义(P ＜0.05).中老年组中度重症及重症AP比例略高于青年组,轻症比例略低于青年组.结论 中老年AP患者在病因、合并疾病、并发症以及严重程度等方面均有其特点.中老年AP患者伴有较多的慢性基础疾病,易发展为重症AP,需要临床医师提高警惕.

高三酰甘油引起的急性胰腺炎在我国的发病率逐渐升高,已成为急性胰腺炎的第二大病因.高脂血症不仅是急性胰腺炎发生的重要病因,还会加重急性胰腺炎病情,引起更严重的器官功能衰竭.目前公认的高三酰甘油血症性胰腺炎(HTGP)的发病机制包括脂肪酸毒性作用、高黏度理论以及遗传理论.提示高三酰甘油是发病的直接原因,其根本原因可能与个体遗传因素有关.了解HTGP的发病机制可更好地指导临床治疗,对于预防急性胰腺炎的复发有重要意义.

目的 探讨埃索美拉唑、阿莫西林、克拉霉素三联用药对老年冠心病伴幽门螺杆菌(Hp)感染患者血脂指标的影响.方法 回顾性分析首都医科大学宣武医院自2018年9月至2020年6月收治的108例老年冠心病伴Hp感染患者的临床资料.54例患者仅接受冠心病常规治疗,纳入未根除组;54例患者在冠心病常规治疗基础上联合埃索美拉唑、阿莫西林、克拉霉素三联用药根除Hp,纳入根除组.连续用药10 d后,比较两组患者治疗前后的血脂指标.结果 两组患者治疗后的总胆固醇、低密度脂蛋白胆固醇水平均低于治疗前,差异有统计学意义(P<0.05);根除组患者治疗后的甘油三酯水平低于治疗前,差异有统计学意义(P<0.05);根除组患者治疗后的高密度脂蛋白胆固醇水平高于治疗前,且高于未根除组,差异有统计学意义(P<0.05).结论 埃索美拉唑、阿莫西林、克拉霉素三联用药根除Hp有利于调节老年冠心病伴Hp感染患者的脂质代谢,可改善患者预后.

目的 探讨影响老年重症及危重症新型冠状病毒感染患者预后的危险因素.方法 选择2020年1月至3月武汉某定点医院某病区收治的61例新型冠状病毒感染老年确诊患者为研究对象,回顾性分析患者的临床资料.采用SPSS 22.0统计软件进行数据分析.根据数据类型,分别采用t检验、秩和检验或χ2检验进行组间比较.采用Cox回归模型进行患者的生存分析.结果 老年重症及危重症新型冠状病毒感染患者病死率为55.7％(34/61).死亡病例具有以下特征:高龄,女性,发病时间长,合并呼吸困难症状比例高,天门冬氨酸氨基转移酶、碱性磷酸酶、乳酸脱氢酶、尿素氮、肌酐、肌酸激酶同工酶、C反应蛋白、中性粒细胞计数水平高,白蛋白、钙离子和淋巴细胞计数水平低.影响老年重症及危重症患者预后的独立危险因素是肌酸激酶同工酶(P=0.000,HR=1.065,95％CI 1.034～1.096),白蛋白(P=0.001,HR=0.867,95％CI 0.797～0.943),钙离子(P=0.000,HR=0.089,95％CI 0.028～0.279)和呼吸困难(P=0.004,HR=6.538,95％CI 1.840～23.237).结论 影响老年重症及危重症新型冠状病毒感染患者预后的独立危险因素为高肌酸激酶同工酶、低白蛋白、低血钙及存在呼吸困难症状.

目的:系统评价糖皮质激素对重症急性胰腺炎(severe acute pancreatitis,SAP)病情及预后的影响.方法:计算机检索PubMed、Medline、Cochrane图书馆、EMBase、中文科技期刊数据库、中国期刊全文数据库以及万方学术期刊全文数据库等,检索时限为2007年1月1日至2020年9月1日,纳入常规治疗+糖皮质激素(研究组)对比常规治疗(对照组)治疗SAP的随机对照试验(randomized controlled trial,RCT),采用改良Jadad评分量表进行文献质量评价后,应用RevMan 5.3统计软件对腹痛缓解时间、血淀粉酶恢复时间、全身炎症反应综合征(systemic inflammatory response syndrome,SIRS)评分、急性生理学和慢性健康状况评价Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分、住院时间、并发症发生率和死亡率等指标进行荟萃分析(Meta分析).结果:共纳入12个RCT,涉及1119例SAP患者.Meta分析结果显示,研究组患者的腹痛缓解时间(MD=-2.03,95％CI=-2.94～-1.13,P<0.0001)、血淀粉酶恢复时间(MD=-2.44,95％CI=-3.40～-1.48,P<0.00001)和住院时间(MD=-7.83,95％CI=-12.02～-3.64,P=0.002)均明显短于对照组,并发症发生率(OR=0.16,95％CI=0.09～0.27,P<0.00001)、死亡率(OR=0.16,95％CI=0.07～0.38,P<0.0001)均明显低于对照组,上述差异均有统计学意义;患者入院后第5日与入院时的SIRS评分、APACHEⅡ评分变化情况,两组比较,差异均无统计学意义(P>0.05).结论:早期应用糖皮质激素治疗SAP有助于缓解病情,改善预后.