儿童支原体肺炎临床诊治分析

Analysis of Clinical Diagnosis and Treatment of Children Mycoplasma Pneumonia

目的观察大环内酯类药物治疗儿童肺炎支原体(MP)感染患者的疗效,为临床治疗药物的选择提供有效参考.方法将筛选的儿童肺炎支原体患者随机分成4组,分别采用红霉素、阿奇霉素、罗红霉素、交沙霉素治疗,评估以上4种药物的药效.筛选单一抗生素治疗效果不明显的重症患者联合甲泼尼龙冲击疗法治疗,对比、评估疗效.实验室中利用支原体分离株做10种抗支原体药物的敏感性试验,找出对MP有效的药物.结果阿奇霉素治疗组患儿的体温下降时间、咳嗽消失时间、X线肺部阴影消失时间显著高于其他3组,总有效率达93.1%;其次为交沙霉素组、罗红霉素组,其有效率分别为84%和82.1%;红霉素组疗效最差,有效率仅为69.2%;重症患者应用甲泼尼龙联合阿奇霉素治疗取得了较好的效果.结论儿童支原体肺炎首选阿奇霉素,对重症肺炎支原体患者给予阿奇霉素联合甲泼尼龙治疗效果明显,无不良反应.

Objective To observe the curative effect of macrolides on children mycoplasma pneumoniae （ MP ） , so as to provide valuable references for the choice of clinical treatment. Method Children with mycoplasma pneumonia were divided into four groups and treated with erythromycin, azithromycin, roxithromycin and josamycin respectively. The severe patients treated with a single antibiotic and less obvious effect were treated in combination with methyl prednisolone,and its therapeutic effects were evaluated. The sensitivities of ten kinds of anti-mycoplasma drugs were tested by using mycoplasma isolates. Results The body temperature decrease time, cough disappearing time and X-ray lung shadow disappearing time of children in azithromycin group were more significantly improved compared with those in the other three groups,the total effective rate was 93. 1%,followed by josamycin group 84% and roxithromycin group 82. 1%, and that of erythromycin group was worst, only 69 . 2%. The treatment with azithromycin combined with methyl prednisolone in the severe cases presented a better effect on the disease. Conclusion Azithromycin is the best choice for children with mycoplasma pneumonia. For severe mycoplasma pneumoniae, the treatment with azithromycin in combination with methyl prednisolone can obtain obvious effects with less adverse reactions.