糖皮质激素佐治小儿肺炎支原体肺炎

Glucocorticoid treatment of children with mycoplasma pneumonia

目的观察糖皮质激素辅助治疗儿童肺炎支原体肺炎的临床疗效。方法将45例肺炎支原体肺炎患儿随机分为两组,对照组25例给予阿奇霉素针剂连续静脉滴注5 d,再改为阿奇霉素干混悬剂口服（服3 d停4 d）,连用2-3个疗程;观察组20例在对照组治疗基础上加用注射用甲基强地松龙（1-2）mg/（kg·d）静脉滴注3 d,治疗7 d后对两组患儿的热退时间、咳嗽缓解时间、胸部X线片改善情况及住院时间进行比较。结果激素治疗组痊愈13例,有效6例,无效1例,总有效率95.0%。非激素治疗组痊愈7例,有效11例,无效7例,总有效率72.0%。激素治疗组治疗差异有统计学意义（P〈0.05）。结论早期应用小剂量、短程糖皮质激素辅助治疗小儿肺炎支原体肺炎,可有效改善患儿临床症状,有效减少或避免肺内、肺外并发症的发生,提高治愈率,避免发生严重并发症。

Objective To observe the clinical effect of glucocorticoid treatment in children with Mycoplasma pneumonia. Methods A total of 45 cases of children with mycoplasma pneumonia were randomly divided into two groups, 25 cases in the control group were given azithromycin injection continuous intravenous infusion of 5D. And then changed to Azithromycin for Suspension oral（3D stop 4D）, 2-3 courses. The observation group of 20 cases based on the control group were treated with injection of methylprednisolone 1-2 mg/（kg od）, intravenous infusion of 3 d, in the two 7 d after treatment groups, the fever, cough relief time time, the improvement of chest X-ray film and duration of hospitalization were compared. Results Hormone treatment group 13 cases were cured, 6 cases effective, 1 cases ineffective, the total effective rate was 95.0%. Non hormone treatment group 7 cases were cured, 11 cases effective, 7 cases ineffective, the total efficiency of 72.0%. Cure rate of hormone treatment group was significantly higher than that of non steroid group,there was statistically significant differenc（P〈0.05）. Conclusion Early application of low-dose, short term glucocorticoid treatment in children with Mycoplasma pneumoniae pneumonia,it can effectively improve the clinical symptoms,reduce or avoidthe occurrence of lung, pulmonary complications, improve the cure rate, to avoid the occurrence of serious complications.