甲基泼尼松龙辅助阿奇霉素对儿童支原体肺炎急性发作的疗效研究

Therapeutic effects of methyllprednisolone combined with azithromycin on acute attack of mycoplasma pneumonia in children

目的探究甲基泼尼松龙辅助阿奇霉素对儿童支原体肺炎急性发作治疗前后的临床效果。方法选择80例支原体肺炎的儿童患者进行研究,患者随机分为研究组和对照组,每组40例,对照组采用阿奇霉素来对患者进行治疗,观察组在使用阿奇霉素量相同的情况下,再给予甲基泼尼松龙进行治疗。并且通过胸部X射线,支气管管镜及肺CT观察研究患者的病理情况,且通过实验室检查结果,患儿治疗前后免疫学指标,并记录治疗前后的变化,判定两组的疗效。结果 2组退热、临床症状、体征改善与住院时间比较,差异均有统计学意义(P<0.05);2组实验室检查结果差异均有统计学意义(P<0.05);2组治疗前后免疫学指标,差异均有统计学意义(P<0.05);2组患者CT、支气管镜表现差异均有统计学意义(P<0.05);研究组总有效率92.50%,对照组总有效率65.00%,差异均有统计学意义(P<0.05)。结论甲基泼尼松龙辅助阿奇霉素对儿童支原体患者临床效果显著,可以显著改善患者的临床症状,提高患者的免疫功能,值得在临床上大力应用推广。

Objective To observe the therapeutic effects of methyllprednisolone combined with azithromycin on acute attack of mycoplasma pneumonia in children. Methods Eighty children patients with mycoplasma pneumonia who were admitted and treated in our hospital from March 2012 to March 2013 were randomly divided observation group and control group,with 40 patients in each group. The patients in control group were treated by azithromycin,however,the patients in observation group,on the basis of control group,were treated by methyllprednisolone. The pathological changes of patients were observed by chest X-ray,CT,bronchoscopy,respectively,moreover,the laboratory indexes including white blood cell count,lymphocyte,serum ferritin,granulocyte,fibrinogen as well as the changes of immunological indexes including IgM,IgG,IgA,CD3^＋,CD3^＋CD4^＋,CD3^＋CD_8~＋,CD4^＋/ CD3^＋,hs-CRP were detected and compared between two groups before and after treatment. Results There were significant differences in pyretolysis,improvement of clinical symptoms and signs,length of staying in hospital between two groups（ P〈 0. 05）. There were significant differences in white blood cell count,lymphocyte,serum ferritin,granulocyte,fibrinogen as well as IgM,IgG,IgA,CD3^＋,CD3^＋CD4^＋,CD3^＋CD_8~＋,CD4^＋/ CD3^＋,hs-CRP before and after treatment between two groups（ P〈 0. 05）. There were significant differences in the examination results by CT and bronchoscopy（ P〈 0. 05）. The total effective rate in observation group was 92. 50%,which was 65. 00% in control group,there was a significant difference between two groups（ P〈 0. 05）. Conclusion The methyllprednisolone combined with azithromycin has obvious therapeutic effects on acute attack of mycoplasma pneumonia in children,which can obviously improve clinical symptoms of patients and enhance patient＇s immune function,thus,which is worth using widely in clinical practice.