阿奇霉素联合头孢菌素治疗小儿支原体肺炎临床疗效及安全性

Clinical efficacy and safety of Azithromycin combined with the treatment of children with mycoplasma pneumonia in community

目的：探究对小儿肺炎支原体肺炎联合采用阿奇霉素及头孢菌素治疗的效果与安全性。方法选取2015年2月至2016年5月中铁三局集团中心医院114例肺炎支原体肺炎患儿，根据治疗方案不同分为对照组（n=57）和研究组（n=57）。两组患儿均于入院后立即给予平喘、止咳、退热等对应处理措施，在此基础上对照组采用阿奇霉素治疗，研究组联合采用头孢他啶与阿奇霉素治疗，两组均持续治疗7 d。统计两组临床疗效及不良反应发生率，对比两组临床症状消失时间、治疗前后两组CD4、与CD4＋/CD8＋水平及血清相关指标[高敏C-反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF-α）、一氧化氮（NO）]水平变化情况。结果研究组临床疗效（96.49%）高于对照组（82.46%），差异有统计学意义（P〈0.05）；研究组退热时间、咳痰咳嗽消失时间、啰音消失时间、X线胸片恢复正常时间均优于对照组，差异有统计学意义（P〈0.05）；治疗前两组CD4＋与CD4＋/CD8＋、hs-CRP、TNF-α、NO水平对比差异无统计学意义（P〉0.05），治疗后，研究组各指标水平优于对照组，差异有统计学意义（P〈0.05）。研究组不良反应发生率（5.26%）与对照组（8.77%）对比差异无统计学意义（P〉0.05）。结论对小儿肺炎支原体肺炎联合采用阿奇霉素及头孢菌素治疗效果显著，可有效改善患儿临床症状及免疫功能，降低血清炎性因子水平，提高治疗效果，且不会增加不良反应发生率。

ObjectiveClinical the effect and safety of azithromycin and the treatment of children with mycoplasma pneumonia in community.Methods114 cases of mycoplasma pneumonia in our hospital from February 2015 to May 2016 were selected. According to different treatment options, they were divided into control group （n=57） and study group （n=57）. Two groups of children were admitted to hospital immediately after treated with asthma, cough, fever and other corresponding treatment measures. On this basis, the control group was treated with azithromycin, the study group was treated with the combination of lamivudine and azithromycin treatment, the two groups were treated for 7 days. We had statistics of the incidence of clinical efficacy and adverse reactions of the two groups, compared two groups of clinical symptoms disappeared time, before and after treatment in two groups of CD4＋ and CD4＋/CD8＋ levels and serum related indicators [high-sensitivity C-reactive protein （hs CRP） and tumor necrosis factor alpha （TNF-α）, nitric oxide （NO）] levels situation.Results The clinical effects of the two groups were compared, the study group （96.49%） was higher than the control group （82.46%）, the difference was statistically significant （P〈0.05）. The study group of fever time, sputum cough disappeared time, rales disappear time, X-ray recovery time were better than the control group, the difference was statistically significant （P〈0.05）. There was no significant difference in the levels of CD4＋, CD4＋/CD8＋, hs-CRP, TNF-α, NO between the two groups before treatment （P〉0.05）, after treatment, the level of each index in the study group was better than that in the control group, the difference was statistically significant （P〈0.05）. There was no significant difference in the incidence of adverse reaction （5.26%） between the study group and the control group （8.77%） （P〉0.05）.Conclusion Community in children with mycoplasma pneumonia with azithromycin and cephalosporin treatment effect is significant, which can effectively improve the patients clinical symptoms and immune function,reduce the serum levels of inflammatory factors and improve the therapeutic effect, and does not increase the incidence of adverse reactions.