红霉素、阿奇霉素序贯治疗与单用阿奇霉素序贯治疗小儿支原体肺炎的疗效比较

Comparison of Therapeutic Efficacy of Erythromycin and Azithromycin Sequential Therapy and Azithromycin Alone in the Treatment of Infantile Mycoplasma Pneumonia

目的:比较红霉素、阿奇霉素序贯治疗与单用阿奇霉素序贯治疗小儿支原体肺炎的疗效。方法:将122例患儿随机分为治疗组62例和对照组60例。治疗组静脉滴注红霉素20～30mg·kg-·1d-1,3～5d;发热减轻即改为静脉滴注阿奇霉素5～10mg·kg-·1d-1,5d,间隔4d后改口服阿奇霉素(5～10mg·kg-1·d-1)3d,停药4d,后据临床症状、体征及胸片选择是否继续口服阿奇霉素,共治疗3～4周。对照组静脉滴注阿奇霉素5～10mg·kg-1·d-1,5d,间隔4d再次静脉滴注阿奇霉素5～10mg·kg-1·d-1,治疗4d后间隔4d改口服阿奇霉素(5～10mg·kg-1·d-1)3d,停药4d后据临床症状、体征及胸片选择是否继续口服阿奇霉素,共治疗3～4周。观察比较2组患者的疗效,退热时间、咳嗽消失时间、肺部湿啰音消失时间、住院时间及不良反应等。结果:治疗组总有效率为90.5%,对照组总有效率为70.5%,2组比较差异有统计学意义(P<0.05)。治疗组退热时间、咳嗽消失时间、肺部湿啰音消失时间及住院时间较对照组缩短,差异有统计学意义(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论:小儿支原体肺炎采用红霉素、阿奇霉素序贯治疗较单用阿奇霉素治疗效果好,病程短,不良反应未增加。

OBJECTIVE： To compare the therapeutic efficacy of erythromycin and azithromycin sequential therapy and azithro- mycin alone in the treatment of mycoplasma pneumonia. METHODS： 122 patients were randomly divided into treatment group （62 cases） and control group （60 cases）. Treatment group was given erythromycin 20-30 mg.kg^-1.d-t added into 10% Glucose injec- tion by intravenous infusion for 3-5 days, and then changed to azithromycin 5-10 mg. kg^-1. d t added into 10 % Glucose injec- tion by intravenous infusion for 5 days once fever alleviated, given azithromycin 5-10 mg. kg^-1 d-^-1orally for 3 days at a interval of 4 days, and continuously given azithromycin orally 4 days alter drug withdrawal according to clinical symptoms, signs and chest X-ray. Treatment course lasted for 3~4 weeks. Control group received azithromycin 5-10 mg-kg^-1.d-^-1 added into 10% Glucose solution by intravenous infusion for 5 d, given azithromycin again with same dose and usage for 4 days at a interval of 4 days, giv- en oral dose of azithromycin for 3 days at a interval of 4 days, and continuously given azithromycin orally 4 days alter drug with- drawal. Treatment course lasted for 3-4 weeks. Therapeutic efficacy, time of fever and cough disappearing, time of lung moist rales disappearing, length of stay and adverse drug reactions were compared between 2 groups. RESULTS： The total effective rate was 90.5% in treatment group and 70.5% in control group, there was statistical significance in difference between 2 groups （P〈 0.05） ; compared with the control group, time of fever and cough disappearing, time of lung moist rales disappearing and length of stay in treatment group were shortened. There was statistical significance （P〈0.05）. There was no statistical significance in the inci- dence of adverse drug reactions between 2 groups （P〉0.05）. CONCLUSION： Erythromycin and azithromycin sequential therapy is better than azithromycin along in the treatment of infantile mycoplasma pneumonia at mycoplasma hyperlipidemia stage and it short- ens treatment course without increase of adverse drug reaction.