阿奇霉素治疗儿童咳嗽变异性哮喘伴肺炎支原体感染临床观察

The Effect Observation of Azithromycin in Treatment of Children with Cough Variant Asthma with Mycoplasma Pneumoniae Infection

目的：探讨阿奇霉素治疗咳嗽变异性哮喘（CVA）伴肺炎支原体（MP）感染患儿的疗效和安全性。方法：将73例CVA伴MP感染患儿随机分为治疗组39例和对照组34例,两组均行常规对症治疗。阿奇霉素治疗组给予阿奇霉素10 mg/（kg.d）静脉滴注,连用5 d停4 d,后改为口服阿奇霉素10 mg/（kg.d）两个疗程（即7 d为1个疗程,每个疗程均服3 d,停4 d）;对照组选用红霉素肠溶胶囊30 mg/（kg.d）口服,连用7~14 d。结果：CVA伴MP感染患儿经阿奇霉素或红霉素治疗后,咳嗽症状评分较治疗前均显著下降,但阿奇霉素治疗组症状评分显著低于红霉素对照组;阿奇霉素治疗组对MP感染的有效率（97.44%）优于红霉素治疗组（82.35%）（P〈0.05）;治疗组不良反应发生率17.95%,显著低于对照组的41.18%,尤其是胃肠道反应及局部疼痛发生率低。结论：阿奇霉素抗支原体感染疗效优于红霉素,可大大改善可能是由支原体引起的CVA的咳嗽程度及睡眠状况。

Objective：To observe the effect and security of azithromycin in treatment of children with cough variant asthma with Mycoplasma pneumoniae infection.Methods：Seventy-three cases of CVA with MP were randomly divided into two groups,39 cases of the treatment group and 34 cases of the control one.Both groups accepted routine treatment,but the treatment group was treated additionally with azithromycin 10 mg/（kg·d） intravenously once a day,for 5 days and after 4 days＇ suspension,oral azithromycin of 10 mg/（kg·d） followed in the next two cycles（7 d a cycle with 3 days for the medicine and 4 days of suspension）.The control group was treated orally with erythromycin enteric-coated capsules,30 mg/（kg·d）,continued for 7~14 d.Results：After the treatment with azithromycin or erythromycin in children with CVA and MP,cough symptom score decreased（P0.05）,especially the symptom score after the treatment with azithromycin was significantly lower than that of erythromycin treatment.In azithromycin group the effective rate of 97.44% was singnificantly higher than the erythromycin group（82.35%）.The adverse reaction rate（17.95%） in treatment with azithromycin was significantly lower than the control group（41.18%） treated with erythromycin,and in particular,fewer gastrointestinal reactions and lower incidence of local pain in azithromycin group were observed.Conclusions：Azithromycin,more effective than erythromycin against Mycoplasma pneumoniae infection,can greatly relieve the cough and improve sleep of children with CVA caused by Mycoplasma pneumoniae infection.