小剂量甲强龙对儿童支原体肺炎疗效及免疫功能影响

Effect of low-dose methylprednisolone on immune function in the treatment of children with mycoplasma pneumonia

目的探讨小剂量甲强龙对儿童肺炎支原体肺炎(MPP)的临床治疗效果及免疫功能的影响。方法 MPP患儿120例随机分组,治疗组64例联合应用阿奇霉素和甲强龙,对照组56例应用阿奇霉素治疗,两组均予止咳祛痰及退热等对症治疗,10 d后,观察两组患儿的症状、体征、胸片改善情况,采用免疫比浊法检查所有儿童血清CRP,采用流氏细胞仪监测T淋巴细胞亚群CD_3^+、CD_4^+、CD_8^+细胞,评价两组临床疗效进行比较。结果治疗组痊愈39例,缓解23例,无效2例,总有效率97.0%,观察组痊愈15例,缓解23例,无效18例,总有效率67.9%。治疗组治疗差异具有统计学意义(P<0.01)。治疗组CD_3^+、CD_4^+CD_4^+/CD_8^+水平明显高于对照组,而CRP、CD_8^+明显低于对照组,差异具有统计学意义(P<0.05)。结论小剂量甲强龙联合阿奇霉素治疗小儿肺炎支原体肺炎可控制免疫反应、增强免疫功能、有效改善患儿临床症状,有效减少和避免并发症,提高治愈率。

Objective To investigate the effect of low-dose methylprednisolone （ MP） on immune function of children with mycoplasma pneumonia （MPP）. Methods 120 children with MPP were randomly divided into two groups. The treatment group （64 cases） was given azithromycin and methylprednisolone, and the control group （56 patients） was treated with azithromycin. Besides, all patients were given symptomatic treatment of cough, phlegm, fever and so on. After 10 days, their symptoms, signs and chest X-ray improvement were observed. The level of CRP was detected by immune turbidity method, and the levels of T lymphocyte subsets CD3＋, CD4＋ and CD8＋ cells were de-tected by flow cytometry. Results In the treatment group, 39 cases were cured, 23 cases were relieved, 2 cases were ineffective, and the total effective rate was 97%. In the observation group, 15 cases were cured, 23 cases were relieved, 18 cases were ineffective, and the total effective rate was 67. 9%. The difference was statistically significant （P〈0. 05）. The levels of CD3＋, CD4＋ and CD4＋ /CD8＋ were significantly higher in the treatment group than in the control group, while the levels of CRP and CD8＋ were significantly lower in the treatment group than in the control group （P〈0. 01）. Conclusion Low-dose methylprednisolone combined with azithromycin can control the immune response, enhance immune function, improve the clinical symptoms, and reduce the complications