阿奇霉素在儿童军团菌肺炎中的应用效果观察

Observation on application effect of azithromycin in Legionella pneumonia in children

目的：探讨儿童军团菌肺炎应用阿奇霉素治疗的临床效果及安全性。方法：采用随机数字表法将该院儿科2011年5月～2013年7月收治的64例儿童军团菌肺炎患儿分为研究组和对照组各32例，对照组采用红霉素治疗及常规对症处理，研究组采用阿奇霉素及常规对症治疗，比较两组患儿的治疗效果、临床症状及体征消失时间、治疗前与治疗1周后的肿瘤坏死因子（TNF-α）、白细胞介素-8（IL-8）、血清铁蛋白的差异。结果：治疗后研究组的TNF-α、IL-8、血清铁蛋白显著优于对照组（P〈0．05）；研究组的咳嗽消失时间、湿罗音消失时间、退热时间显著短于对照组（P〈0．05）；研究组和对照组的疗效分布差异有统计学意义，研究组的优于对照组（P〈0．05）；研究组的总有效率为93．75％，高于对照组的84．38％，但差异无统计学意义（P〉0．05）；两组不良反应率比较差异无统计学意义（χ^2=1．016，P=0．313）。结论：儿童军团菌肺炎应用阿奇霉素治疗较使用红霉素的临床效果更好，同时不会增加不良反应率。

Objective： To explore the clinical effect and safety of azithromycin in treatment of children with Legionella pneumonia. Methods： Sixty -four children with LegioneUa pneumonia treated in pediatric department of the hospital from May 2011 to July 2013 were randomly divided into study group and control group by random number table, 32 children in each group; the children in control group were treated with erythromycin and conventional therapy, while the patients in study group were treated with azithromycin and conventional therapy ; the curative effects, disappearance times of clinical symptoms and signs, the levels of serum tumor necrosis factor - α （ TNF - α）, interleukin - 18 （ IL - 18） and ferritin before treatment and at one week after treatment in the two groups were compared. Results： The levels of serum TNF -α, IL -8 and ferritin after treatment in study group were statistically significantly higher than those in control group （P 〈 0. 05 ） ; the disappearance times of coughing and moist rales, the fever clearance time in study group were statistically significantly shorter than those in control group （ P 〈 0.05 ） ; the curative effect in study group was statistically significantly better than that in control group （ P 〈 0. 05） ; the total effective rate in study group was 93.75%, which was higher than that in control group （84. 38% ）, but there was no statistically significant difference （ P 〉 0. 05 ）, there was no statistically significant difference in the incidence rate of adverse reactions between the two groups （χ^2 = 1. 016, P = 0. 313） . Conclusion ： Compared with erythromycin, the clinical efficacy of azithromycin in treatment of Legionella pneumonia in children is better, and it doesnt increase the incidence rate of adverse reactions.