头孢他啶联合阿奇霉素治疗儿童社区获得性肺炎临床观察

Clinical observation of ceftazidime combined with azithromycin therapy for children with community-acquired pneumonia

目的：观察头孢他啶联合阿奇霉素治疗儿童社区获得性肺炎的临床效果。方法将80例社区获得性肺炎患儿按照随机、自愿的原则分为对照组（n=40）和观察组（n=40）,对照组在常规治疗基础上加用头孢他啶,观察组在对照组治疗基础上加用阿奇霉素,疗程7~14 d。比较两组患儿临床症状缓解时间、总有效率以及治疗前后外周血白细胞总数（WBC）、红细胞沉降率（ESR）和C-反应蛋白（CRP）变化。结果观察组患儿体温开始下降时间[（2.4±177;1.2）d VS （3.8±177;1.8）d]、咳嗽消失时间[（3.2±177;1.8）d VS （4.6±177;2.2）d]、肺部啰音消失时间[（4.4±177;1.8）d VS （5.6±177;2.4）d]和住院时间[（9.5±177;2.6）d VS （11.2±177;3.8）d]均明显小于对照组,差异均有统计学意义（均P〈0.05）；观察组总有效率明显高于对照组,差异有统计学意义（95.0%VS 77.5%,χ2=6.421, P〈0.05）；治疗前两组间WBC、ESR和CRP差异无统计学意义（均P〈0.05）,治疗后两组WBC、ESR和CRP均明显下降,且观察组下降更为明显,与对照组治疗后相比差异有统计学意义（均P〈0.05）。结论头孢他啶联合应用阿奇霉素可以减轻社区获得性肺炎患儿的炎症反应,临床效果显著,值得推广应用。

Objective To investigate the clinical effect of ceftazidime combined with azithromycin therapy for children with community-acquired pneumonia. Methods 80 children with community-acquired pneumonia were randomly and voluntarily divided into the control group （n=40） and observation group （n=40）. The control group were given ceftazidime on the basis of conventional treatment,while observation group were given azithromycin on the basis of treatment of control group.The course of the treatment was 7~14 d. The clinical symptoms, total effective rate and changes of total number of white blood cell （WBC）, erythrocyte sedimentation rate （ESR） and C-reactive protein （CRP） were compared after treatment. Results The body temperature starts to drop time[（2.4±177;1.2）d VS （3.8±177;1.8）d], cough disappearing time[（3.2±177;1.8）d VS （4.6±177;2.2）d], lung rale disappearing time[（4.4±177;1.8）d VS （5.6±177;.4）d]and hospitalization time[（9.5±177;2.6）d VS （11.2±177;3.8）d]of the observation group were significantly shorter than the control group（all P〈0.05）.Total effective of the observation group was obviously higher than that of control group,difference was statistically significant （95.0%VS 77.5%,χ2=6.421, P〈0.05）. There were no statistically significant difference about WBC, ESR and CRP between the two groups before treatment（all P〈0.05）. All of them drop obviously after treatment and the observe group drop showed more obvious（all P〈0.05）. Conclusion Ceftazidime combined with azithromycin can reduce the inflammatory response in children with mycoplasma pneumonia and the clinical effect is remarkable and it is worth popularization and application.