摘要
目的:分析甲泼尼龙与吸入用乙酰半胱氨酸(NAC)联用治疗儿童肺炎支原体肺炎(MPP)临床效果。方法:选取常熟市第二人民医院儿科2021年10月—2022年10月收治的MPP患儿116例,采用随机数字表法将患者分为对照组与观察组各58例。两组患儿均给予临床入径后的常规和对症支持治疗,对照组在此基础上增加静脉滴注甲泼尼龙琥珀酸钠,观察组在对照组的基础上,联合采用雾化吸入NAC溶液。比较两组的临床疗效以及治疗前后肺功能的变化、超敏C反应蛋白(hs-CRP)、乳酸脱氢酶(LDH)和白细胞介素-6(IL-6)的水平,并统计治疗过程中所发生的不良反应(AR)。结果:观察组患儿治疗总有效率(96.6%)高于对照组(82.8%),差异有统计学意义(χ^(2)=5.949,P<0.05)。在退热时间上,两组比较,差异无统计学意义(P>0.05),但观察组患儿咳嗽症状减轻的时间、肺部啰音消失的时间和临床治愈时间均短于对照组,差异有统计学意义(P<0.05)。两组患儿治疗后的第一秒用力呼气量(FEV1)、用力肺活量(FVC)、呼气峰值流速(PEF)和最大呼吸中段流速(MMEF 25%~75%)均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。治疗后,两组患儿的hs-CRP、LDH、IL-6水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。两组患儿AR总发生率比较,差异无统计学意义(χ^(2)=1.681,P=0.485)。结论:甲泼尼龙琥珀酸钠联合吸入用NAC可促进MPP患儿临床症状尽快改善,并有效改善患儿的肺功能及降低炎性因子表达水平。
Objective To analyse the efficacy of methylprednisolone sodium succinate combined with inhalation of acetylcysteine solution in the treatment of children with mycoplasma pneumoniae pneumonia(MPP).Methods From October 2021 to October 2022,116 children with MPP diagnosed in Changshu City Second People’s Hospital were selected.Participants were randomly assigned to a control group(n=58)and an observation group(n=58).Both groups of children were given routine and symptomatic support treatment after clinical access.On the basis of this,the control group was added with intravenous drip therapy of methylprednisolone sodium succinate.On the basis of the control group,the observation group was combined with inhalation therapy of acetylcysteine(NAC)solution.Compare the clinical efficacy and changes of pulmonary functio before and after treatment,as well as the levels of hypersensitive C-reactive protein(hs-CRP),lactate dehydrogenase(LDH),and interleukin-6(IL-6)between the two groups,and count the adverse reactions(AR)that occurred during the treatment process.Results The total effective rate of treatment in the observation group(96.6%)was higher than that in the control group(82.8%)(χ^(2)=5.949,P<0.05).In terms of antipyretic time,there was no significant difference between the two groups(P>0.05),but the observation group had shorter time to relieve cough symptoms,disappearance of lung rales,and clinical cure time compared to the control group(P<0.05).The first second forced expiratory volume(FEV1),forced vital capacity(FVC),peak expiratory flow rate(PEF)and maximum middle respiratory flow rate(MMEF 25%~75%)of the two groups after treatment were higher than those before treatment,and the observation group was higher than the control group(P<0.05).The average levels of hs-CRP,LDH,and IL-6 in the two groups of children after treatment were lower than those before treatment,and the observation group was lower than the control group(P<0.05).There was no significant difference in the total incidence of AR between the two groups of children(χ^(2)=1.681 and P=0.485).Conclusion Methylprednisolone sodium succinate combined with inhalation of NAC can improve the clinical symptoms of children with MPP as soon as possible,effectively improve the pulmonary function of children with MPP,and reduce the expression level of inflammatory factors.
作者
牛文泽
刘俊
NIU Wenze;LIU Jun(Department of Pediatrics,Changshu City Second People’s Hospital,Changshu,Jiangsu,215500,China)
出处
《医药前沿》
2023年第6期30-33,共4页
Journal of Frontiers of Medicine
基金
苏州市科技局“科教兴卫”青年基金项目(KJXW2020065)。
关键词
甲泼尼龙
吸入用乙酰半胱氨酸溶液
支原体肺炎
肺功能
Methylprednisolone sodium succinate
Inhalation of acetylcysteine solution
Mycoplasma pneumoniae pneumonia
Pulmonary function
