阿奇霉素对小儿支原体肺炎患者C反应蛋白与心肌酶含量影响及临床疗效

Effects of azithromycin on C-reactive protein and myocardial enzyme levels in patients with mycoplasma pneumonia and its clinical effects

目的:通过检测经阿奇霉素治疗前后支原体肺炎(MP)患儿血清心肌酶及C反应蛋白(CRP)活性,探讨阿奇霉素的临床疗效。方法:观察组144例MP患儿根据病情分成重症MP组(60例)和轻症MP组(84例),另选同期108例健康儿童作为对照组,MP患儿接受阿奇霉素治疗,对比分析治疗前后小儿血清心肌酶[天冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)及其同工酶(CK-MB)]与CRP的活性。结果:治疗前,重症MP组、轻症MP组患儿血清AST、LDH、CK、CKMB及CRP均高于对照组(P<0.05),除轻症MP组与对照组小儿的CK值比较无统计学差异(P>0.05)外,其余皆具有统计学差异(P<0.05)。经阿奇霉素治疗后,重症MP组、轻症MP组患儿血清AST、LDH、CK-MB及CRP均较治疗前明显降低(P<0.05)。治疗总有效率为94.4%,不良反应轻微。结论:重症肺炎患儿可能存在心肌损伤,阿奇霉素在治疗MP肺炎的同时能更好地治疗MP肺炎并发的心肌损伤。

OBJECTIVE To investigate the clinical efficacy of azithromycin by detecting serum myocardial enzymes and C-re- active protein （CRP） activity in patients with mycoplasma pneumonia （MP） before and after treatment with azithromycin. METHODS 144 cases of observation group were divided into 60 cases with severe MP group and 84 cases with mild MP group. At the same period 108 cases of healthy children were enrolled as the control group. CRP and myocardial enzyme inclu- ding aspartate aminotransferase （AST）, lactate dehydrogenase （LDH）, creatine kinase （CK） and its co-workers enzyme （CK- MB） were compared and analyzed before and after treatment. RENULTS Before treatment, in severe MP group, mild MP group the serum AST, LDH, CK, CK-MB and CRP were higher than those of the control group（P〈0. 05）, except for mild MP group and the control group CK levels in children was no significant difference （P〈0.05）. After azithromycin treatment, serum AST, LDH, CK-MB and CRP in severe MP group, mild MP group were significantly decreased （P〈0. 05）. The total effective rate was 94. 4%, adverse reactions were mild. CONCLUSION Children with severe pneumonia may exist myocardial iniury, AST, LDH, CK-MB and CRP can be used for evaluation of children with pneumonia and as concomitant important indi- cators of myocardial injury, azithromycin can significantly and effectively reduce these indicators.