小剂量甲基强的松龙治疗儿童重症肺炎支原体肺炎的临床疗效分析

Curative effect of low-dose methylprednisolone in children with severe Mycoplasma pneumoniae pneumonia： observation of 40 cases

目的探讨小儿重症肺炎支原体肺炎（SMPP）应用小剂量甲基强的松龙治疗的临床疗效。方法40例1—11岁的SMPP患儿，分为两组，21例除接受常规抗生素和对症治疗外，加用小剂量甲基强的松龙（1-2mg／kg·d，1次／d，静滴，3-5d后改为口服甲泼尼松龙1周内减停）（激素治疗组），19例仅接受常规抗生素和对症治疗（对照组）。比较两组的主要临床症状体征消失时间、影像学、实验室指标恢复正常时间及治愈率。结果治疗组临床症状、体征消失时间，影像学、实验室指标恢复正常时间均短于对照组，均P〈0．05；治疗组有效率95．24％，显著高于对照组（78．9％，P〈0．05）。结论小剂量甲基强的松龙治疗儿童SMPP具有临床症状体征好转快，影像学、实验室指标恢复快，临床无明显不良反应，治愈率高等优点，建议早期使用。

Objective To investigate the curative effect of low-dose methylprednisolone in treatment of Severe Mycoplasma pneumomae pneumonia （SMPP） in pediatric patients. Methods Forty child with SMPP, aged 1-10. were randomly divided into 2 groups： 21 cases undergoing, in addition to conventional antibiotic and symptomatic therapy, methylprednisolone 1-2 mg/kg, d q.d.iv drop for 3-5 days and then oral administration for at most 1 week （methylprednisolone group）, and 19 cases undergoing conventional antibiotic and symptomatic therapy. The recovery times of clinical symptoms and signs . lung imaging, and laboratory indexes, C-reactive protein （CRP）, alanine aminotransferase tALL and MB isoenzyme of creatine kinase （CKMB）, and the cure rate were observed. Results Compared with the control group, the clinical symptoms and signs disappeared earlier, and the recovery times of lung imaging and CRP. ALT. and CKMB, were all significantly shorter （all P 〈0.05）. The effective rate of the methylprednisolone group was 95.24%. significantly higher than that of the control group （78.9%. P 〈0.05）. Conclusion Speeding up the improvement of clinical symptoms and signs, lung imaging, and laboratory indexes, and increasing the cure rate, low-dose methylprednisolone therapy is effective to treat SMPP in children and its early application is recommended.