阿奇霉素联合痰热清注射液对老年MPP患者CRP和免疫球蛋白的影响

Effects of Azithromycin Combined with Tanreqing Injection on CRP and Immunoglobulin in Senile Patients with MPP

目的探讨阿奇霉素联合痰热清注射液对老年支原体肺炎患者外周血c反应蛋白（CRP）和免疫球蛋白的影响。方法选取2012年6月至2013年9月深圳市妇幼保健院收治的老年支原体肺炎患者62例，以随机数字表法分为A组和B组，各31例。A组采用阿奇霉素0．5g／d，溶于0．9％氯化钠溶液250mL，静脉滴注，治疗1周；B组在阿奇霉素的基础上加用痰热清注射液，20mL／d，溶于0．9％氯化钠溶液250mL，静脉滴注，治疗1周；比较两组临床疗效和并发症发生情况。采用全自动生化分析仪和酶联免疫吸附试验试剂盒检测两组血清CRP和免疫球蛋白（IgA、IgG、IgM）水平，并以30例健康志愿者为对照组，进行同步分析。结果A组患者临床有效率为74．2％（23／31），B组为93．5％（29／31），B组显著高于A组（x2=4．292，P=0．040），A组和B组并发症发生率[32．3％（10／31）比19．4％（6／31）]，差异无统计学意义（x2=1．348，P=0．192）。此外，治疗前A、B两组的血清CRP水平显著高于对照组（LSD-t=31．63，30．87，均P=0．000），IgA、IgG、IgM水平显著低于对照组（均P=0．000）；治疗后，A组患者的血清CRP水平显著高于B组（P〈0．05），IgA、IgG、IgM水平显著低于B组（LSD—t=1．77—7．76，P=0．04～0．000）。结论阿奇霉素联合痰热清注射液能提高老年支原体肺炎患者外周血免疫球蛋白IgA、IgG、IgM水平，利于改善免疫功能，抑制炎症反应。

Objective To observe the effect of azithromycin combined with Tanreqing injection on C- reactive protein（CRP） and immunoglobulin in senile patients with mycoplasma pneumoniae（MPP）. Methods Total of 62 elderly patients with MPP hospitalized in Shenzhen Maternal and Child Health Hospital Affilia- ted to Southern Medical University from Jun. 2012 to Sep. 2013 were selected and divided into group A （31 cases） and group B （31 cases）. Patients in group A were treated with azithromycin,O. 5 g/d,dissolved in 250 mL normal saline and dripped intravenously for a week, while those in group B were given Tanreqing injection at the same time, 20 mL/d, dissolved in 250 mL normal saline and dripped intravenously for a week. Both clinical efficacy and complication incidence of the two groups were compared. The peripheral blood of every subject was extracted and detected for IgA, IgG, IgM and CRP with automatic clinical chemis- try analyzer and ELISA kits. 30 healthy volunteers were selected as control group to do the serum assay. Results The clinical efficacy of group B was significantly higher than that of group A [ 93.5 % （29/31 ） vs 74.2% （23/31）, X2 = 4. 292 ,P = O. 040 ], and the complication rate of the two groups had no statistically significant difference [32.3% （10/31） vs 19.4% （6/31） ,x2 = 1. 348,P =0. 192]. Before treatment,the serum CRP level of patients in group A or group B were significantly higher than that of the control group （ LSD-t = 31.63,30. 87, P = 0. 000 ）, while IgA, IgG, IgM were lower （ P = O. 000 ）. After treatment, the ser- um CRP level of group B were significantly higher than that of group A （ P 〈0. 05 ） , while IgA, tgG, IgM were significantly lower（ LSD-t = 1.77-7.76, P = 0.04-0. 000 ）. Conclusion Azithromycin combined with Tanreqing injection can increase peripheral blood IgA ,IgG ,IgM of elderly MPP patients, which is helpful to improve humoral immune function and restrain inflammatory response.