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2010985ClinicalMedicationJournal561121*1(100853)2(710089)132,4d,,,,,1,;;;R5631;9771A1672-3384(2010)-05-0056-03(CAP),2040,CAP,CAP,CAP,CAP,,,[1],,,1,1,,32,4d201063,,39,,,,,66,,42,CT,3d,,38~389,,,CT,,,1d69,,,/,,61010,202388,80,115/70mmHg,18,,:(WBC)376109L-1,(N)0875,221ngml-1,C(CRP)671mgdl-1(,2Lmin-1):pH741,(PaO2)721mmHg,(PaCO2)364mmHgCT(201069):,66*:,,2010985ClinicalMedicationJournal57,:32010610/,3d,388,CRP612,,,,120mg,80mg,2,24h,CRP,3d368,WBC911109L-1,N0918,CRP742mgdl-1,612(388,WBC139109L-1,N0830,CRP207mgdl-1)617,,,74710,366,WBC372109L-1,N0565,CRP02mgdl-1,CT:,626CT,,715,,41,,,,CT,,,CAP(2006),,,PaO260mmHg,PaO2/FiO2=248300,CT,48h50%,41,63,3dCT,69CT50%,[2],,,,(ARDS),CAP[3],,,,,,,,,,,,[1]42,,,,PaO260mmHg[4]2010985ClinicalMedicationJournal58,PaO260mmHg,,,,,,[2,5],HantavirusADRS,;,,[6],6(RCT),,13,PaO270mmHg,-35mmHg,;,43,,,,,Agusti[7]:,,,[8-9],80~160mgd-1(85%),80~320mgd-1,2~3,3~5d;(ARDS),320~640mgd-1,3~5d,,3~4,21d[10],,[9]1/4,3~5d1(10~20mg)40mg,120mg,80mg,bid,,,3d,,,,40mg,81,3~5d1/3,24mgd-1,,4d,21d5,,,,,,,,,,[1]Garcia-VidalC,CalboE,PascualV,eta.lEffectsofsystemicsteroidsinpatientswithseverecommunity-acquiredpneumonia[J].EurRespirJ,2007,30:951-956.[2].[J].(),2009,30:1-4.[3]..[J].,2005,17:241-242.[4]MatsushimaT,JapaneseRespriatorySociety.TheJapaneseRespria-torySocietyguidelinesformanagementofcommunity-acquiredpneumoniainadults[J].NipponRinsho,2003,61:677-681.2010985ClinicalMedicationJournal5911,21*1(100853)2(046000)156,2,2,,,,;;;;;R97715A1672-3384(2010)-05-0059-04,,,,,;,,,19936WHO,44~61mmolL-1[1]1,,,*:,,1,,56,2,220104320103,38~39,,,,,,,,,CTMRI,,40mgd-1,29mmolL-1,,[5].[J].,2009,23:354-355.[6]Brie1M,BoscacciR,FurrerH,eta.lAdjunctivecorticosteroidsforpneumocystisjirovecipneumoniainpatientswithHIVinfection:aMeta-analysisofrandomizedcontrolledtrials[J].BMCinfectDis,2005,5:101.[7]AgustC,RaA,FilellaX,eta.lPulmonaryinfiltratesinpatientsreceivinglong-termglucocorticoidtreatment.etiology,prognosticfactors,andassociatedinflammatoryresponse[J].Chest,2003,123:488-498.[8]..[J].,2003,15:669-672.[9].SARS[J].,2003,17:239-240[10].[J].,2003,26:326-327