儿童肺炎支原体感染后辅助治疗的疗效

Auxiliary therapy after mycoplasma pneumoniae infection of children

目的观察抗过敏疗法、糖皮质激素吸入疗法、免疫调节剂对防治儿童肺炎支原体 (MP)感染的疗效。方法将 12 0例MP感染患儿 ,在用阿奇霉素或红霉素治疗 2～ 3周的基础上 ,按照辅助疗法的不同分成四组 :原方案组 ,克敏能组 ,普米克吸入组 ,胸腺肽或转移因子注射组。用药前后检测外周静脉血嗜酸性粒细胞阳离子蛋白 (ECP)、嗜酸性粒细胞 (EOS)、白介素 - 4 (IL 4 )和总IgE(T IgE)。结果后三组疗法的临床症状消失时间较原方案组显著缩短 ,且 3个月内反复呼吸道感染次数减少。其中 ,普米克吸入组疗程最短。原方案组除ECP在用药后降低外 ,EOS、IL 4和T IgE均无明显变化 ;而原方案加辅助疗法 3组用药后ECP、EOS、IL 4都有明显下降 ,差异有统计学意义 ,T IgE水平基本无变化。结论在缩短疗程方面 ,加用小剂量激素吸入疗法是首选的辅助疗法 ;免疫调节剂和抗过敏药物能够促进儿童肺炎支原体感染后的康复 ,降低复发频率 ,从而提高儿童肺炎支原体感染的防治水平。

Objective To compare the effect of anti-hypersensitivity drugs, glucocorticoid inhalation therapy and immunomodulator in prevention and treatment of mycoplasma pneumonae (MP) infection. Methods Having been treated with azithromycin or erythromycin for 2～3 weeks, 120 MP infected cases were divided to four different groups according to different auxiliary therapy:control group, clarityne group, pulmicort inhaling group and thymosin or TF(transfer factor) injection group, then ECP, EOS, IL-4 and T-IgE were detected before and after medication. Results The clinical recovery to symptom free period in treatment groups was shortened significantly compared with that in control group, and the frequency of the recurrent respiratory tract infection were reduced significantly in treatment groups too. The effect in pulmicort inhaling group was the best. ECP, EOS, IL-4 of all groups decreased significantly except total IgE after therapy. Conclusion Little dosage of glucocorticoid inhalation therapy is the best auxiliary therapy to prevent and treat MP infection. Anti-hypersensitivity and immunomodulator medicine can promote the recovery of MP infection, and reduce chance of recurrent infection, and so that the improve the prevention and treatment of MP infection.