甲泼尼龙用于肺炎支原体感染患儿及对肿瘤坏死因子-α的影响

Research on Effect of Methylprednisolone on TNF- α in Children with Mycoplasma Pneumoniae Infection

目的观察不同剂量甲泼尼龙用于肺炎支原体感染患儿及对肿瘤坏死因子-α(TNF-α)的影响。方法将医院收治的72例未接受治疗的支原体肺炎患儿随机分为中等剂量组、小剂量组和常规治疗组,3组患儿均给予阿奇霉素治疗,中等剂量组和小剂量组患儿在此基础上分别给予5 mg/kg和1 mg/kg甲泼尼龙,同时选取来医院进行健康体检的24例健康儿童作为健康对照组。比较4组儿童治疗前、治疗后4 d、治疗后7 d血清TNF-α水平,以及3组患儿的治疗有效率。结果中等剂量组和小剂量组患儿治疗有效率显著高于常规治疗组(P<0.05),住院时间、胸片部X线摄片阴影消退时间、发热时间均显著低于常规治疗组(P<0.05);治疗前,治疗后4 d、治疗后7 d中等剂量组和小剂量组患儿TNF-α水平均无显著差异(P>0.05);中等剂量组和小剂量组患儿TNF-α治疗前、治疗后4 d高于健康对照组(P<0.05),治疗后7 d与健康对照组无显著差异(P>0.05);常规治疗组治疗前,治疗后4 d、治疗后7 d TNF-α水平均显著高于健康对照组(P<0.05)。结论中等剂量和小剂量甲泼尼龙均能够显著降低支原体肺炎患儿TNF-α水平,提高治疗有效率。

Objective To investigate the effect of different doses of methylprednisolone on tumor necrosis factor-α （ TNF-α） in chil-dren with Mycoplasma pneumoniae infection. Methods 72 untreated children patients with Mycoplasma pneumonia admitted to hospital were randomly divided into the middle-dose group, low-dose group and conventional treatment group. The 3 groups were given azithromycin, while on this basis the middle-dose group and the low-dose group were given 5 mg/kg and 1 mg/kg of methylpred-nisolone;at the same time 24 healthy children with physical examination were selected as the healthy control group. The serum TNF-αlevels before treatment, on 4, 7 d after treatment were compared among 4 groups and the treatment effective rates were compared among 3 treatment groups. Resuts The effective rate in the middle-dose group and the low-dose group was significantly higher than that in the conventional treatment group （ P〈0. 05 ）; the hospitalization time, disappearance time of chest X-ray shadow and fever time were significantly lower than those in the conventional treatment group （ P〈0. 05 ）;serum TNF-α level before treatment, on 4, 7 d after treat-ment had no statistically significant difference between the middle-dose group and the low dose group （ P〉0. 05 ）;serum TNF-α level before treatment, on 4 d after treatment in the middle-dose group and the low-dose was higher than that in the healthy control group （ P〈0. 05 ） , but which on 7 d after treatment had no statistically significant difference between the middle dose group and the low-dose group with the healthy control group （ P〉0. 05 ）;serum TNF-α level before treatment, on 4, 7 d after treatment in the convention-al treatment group was significantly higher than that in the healthy control group （ P〈0. 05 ） . Conclusion Middle-dose and low-dose methylprednisolone can significantly reduce the serum TNF-α level in children with Mycoplasma pneumonia and improve the treatment effect.