多西环素在儿童大环内酯类耐药支原体肺炎治疗中的疗效分析

目的观察多西环素治疗大环内酯类耐药性支原体肺炎的临床疗效。方法选取〉8岁临床确诊为大环内酯类耐药支原体肺炎患儿105例，分为对照组（n=53）与观察组（n=52），对照组使用阿奇霉素10mg／（kg·d）口服，观察组使用多西环素2mg／（kg·d），首日剂量加倍，比较两组患儿治疗有效率及用药后体温恢复时间、咳嗽明显好转时间、肺部哆音消失时间及甲泼尼龙使用率等指标。结果对照组治愈、有效34例（64．2％），观察组治愈、有效48例（92．3％），两组比较差异有统计学意义（P〈0．05），观察组用药后体温恢复时间、用药后咳嗽明显好转时间、用药后肺部哆音消失时间及甲泼尼龙使用率均低于对照组，两组比较差异有统计学意义（P〈0．05）。随访过程中未见观察组患儿出现牙齿黄染、骨骼发育不良、二重感染等不良反应。结论多西环素在〉8岁儿童的耐药支原体肺炎治疗中临床疗效较好，可以提高治疗有效率，减少甲泼尼龙使用率。

Objective To observe the treatment efficacy of doxycycline against macrolide-resistant mycoplasma pneumoniae pneumonia in pediatric patients. Methods A total of 105 pediatric patients up to age of 8 with macrolide-resistant mycoplasma pneumoniae pneumonia were analyzed and they were randomly divided into control goup （ 53 cases ） and observation group （ 52 cases ） . Patients in the control group accepted Azithromycin therapy （ 10mg/ （ kg·d ） ） and observation group accepted Doxycycline therapy （ 2mg/ （ kg·d ） ） . After treatment, their clinical efficacy and safety were compared and analyzed. Results In the control group 34 cases got effective cure （ 64.2% ） and in the observation group 48 cases got effective cure （ 92.3% ） , which was statistically significant （ P〈0.05 ） . Observation group was superior to control group in terms of abatement of fever, cough easing, disappear of lung rale and methylprednisolone usage. In the process of follow-up, no adverse reaction was observed , such as yellowing teeth, skeletal dysplasia and double infection. Conclusion Doxycycline effectively increases the cure rate of macrolide-resistant mycoplasma pneumoniae pneumonia in pediatric patients aged up to 8 years and reduces methylprednisolone usage.