摘要
目的探讨阿奇霉素联合糖皮质激素治疗儿童重症肺炎支原体肺炎(severe mycoplasma pneumoniae pneumonia, SMPP)的效果及对机体炎性因子的影响。方法选取儿童SMPP 100例,根据治疗方法不同将其分为研究组和对照组两组各50例。在基础对症处理上,研究组采用阿奇霉素联合甲泼尼龙治疗,对照组仅给予阿奇霉素治疗,总疗程均为15 d。观察比较两组治疗后临床效果,治疗期间症状和体征消失时间,治疗前后血清炎性因子水平,以及治疗期间不良反应发生情况。结果治疗后,研究组总有效率90.0%高于对照组总有效率66.0%,差异有统计学意义(P<0.01)。治疗期间,研究组发热、咳嗽及肺部湿啰音消失时间均短于对照组,差异有统计学意义(P<0.05)。治疗前,两组血清超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)和肿瘤坏死因子α(TNF-α)水平比较差异无统计学意义(P>0.05)。治疗后,两组血清hs-CRP、IL-6和TNF-α水平均较治疗前降低,且研究组血清hs-CRP、IL-6和TNF-α水平均低于对照组,差异有统计学意义(P<0.05)。治疗期间,两组不良反应总发生率比较差异无统计学意义(P>0.05)。结论阿奇霉素联合糖皮质激素治疗儿童SMPP可提高临床效果,缩短症状和体征持续时间,减轻机体炎症反应程度,且治疗安全性较好。
Objective To investigate the effect of Azithromycin combined with glucocorticoid in the treatment of severe Mycoplasma pneumoniae pneumonia(SMPP) in children and its influence on inflammatory factors. Methods One hundred children with SMPP were divided into research group(n=50) and control group(n=50) according to different treatment methods. In terms of basic symptomatic treatment, the research group was treated with Azithromycin and methylprednisolone, while the control group was treated with Azithromycin alone. The course of treatment was 15 d. The clinical effect, the disappearance time of symptoms and signs, the level of serum inflammatory factors before and after treatment, and the occurrence of adverse reactions were observed and compared between the two groups. Results After treatment, the total effective rate of the research group was 90.0% higher than 66.0% of the control group(P<0.01). During the treatment period, the disappearance time of fever, cough and lung wet rales in the research group was significantly shorter than that in the control group(P<0.05). Before treatment, there was no significant difference in serum high-sensitivity C-reactive protein(hs-CRP), interleukin-6(IL-6) and tumor necrosis factor α(TNF-α) level between the two groups(P>0.05). After treatment, the levels of serum hs-CRP, IL-6 and TNF-α in the two groups were lower than those before treatment, and the levels of the above indicators were significantly lower in the research group than in the control group(P<0.05). There was no significant difference in total incidence of adverse reactions between the two groups(P>0.05). Conclusion Azithromycin combined with glucocorticoid can improve the clinical effect of SMPP in children, shorten the duration of symptoms and signs, and reduce the degree of inflammatory response, and the treatment is of good safety.
作者
高虹
薛红霞
GAO Hong;XUE Hong-xia(Department of Pediatrics,Maternal and Child Health Hospital of Shijiazhuang,Shijiazhuang 050000,China;Department of Pediatrics,the Third Hospital of Shijiazhuang,Shijiazhuang 050000,China)
出处
《临床误诊误治》
2020年第5期60-63,共4页
Clinical Misdiagnosis & Mistherapy
基金
河北省医学科学研究重点课题(20150885)。
