阿奇霉素联合糖皮质激素治疗小儿大叶性肺炎临床效果及对血清CRP、IL-6和PCT水平的影响

Therapeutic effects of azithromycin combined with glucocorticoid on lobar pneumonia in children and its effects on serum levels of CRP,IL-6 and PCT

目的分析阿奇霉素联合糖皮质激素治疗小儿大叶性肺炎的临床效果,及对患儿血清C-反应蛋白(Creactive protein,CRP)、白介素-6(Interleukin,IL-6)、降钙素原(procalcitonin,PCT)水平的影响。方法收治的支原体性大叶性肺炎小儿患者100例,随机分为观察组和对照组,每组50例。观察组采用阿奇霉素治疗,对照组采用阿奇霉素联合糖皮质激素进行治疗。患儿均随访1个月,观察2组患者治疗后咳嗽明显减轻时间、发热消退时间、肺部阴影吸收时间,比较治疗前、后患儿肺功能变化,比较2组患儿治疗前、后血清CRP、IL-6、PCT水平变化。结果观察组咳嗽减轻时间、发热消退时间、胸片示肺部阴影消失时间均显著低于对照组(P<0.05);观察组治疗后FEF 25%~75%为(1.86±0.53)L/s,FEF 75%为(0.95±0.48)L/s,FEF 50%为(1.99±0.83)L/s,FEF25%为(3.42±0.68)L/s,均显著高于对照组,2组比较差异均有统计学意义(P<0.05);观察组治疗后CRP、IL-6、PCT,均较对照组水平低(P<0.05)。结论阿奇霉素联合糖皮质激素治疗小儿大叶性肺炎临床疗效显著,有效改善血清CRP、IL-6、PCT水平。

Objective To observe the therapeutic effects of azithromycin combined with glucocorticoid on lobar pneumonia in children and its effects on serum levels of C-reactive protein（CRP）,interleukin（IL-6） and procalcitonin（PCT）. Methods A total of 100 children patients with mycoplasma lobar pneumonia who were admitted and treated in our hospital in 2014 were randomly divided into two groups： observation group（n = 50） and control group（n = 50）. The patients in control group were treated by azithromycin only,however,the patients in observation group were treated by azithromycin combined with glucocorticoid,with 1-month follow-up for both grous. The cough relief time,fever regression time and pulmonary shadow absorption time were observed for both groups,moreover,the changes of pulmonary function,serum levels of CRP,IL-6 and PCT before and after treatment were observed and compared between two groups. Results The cough relief time,fever regression time and pulmonary shadow absorption time in observation group were significantly lower than those in control group（P〈0.05）. After treatment the FEF 25% - 75% [（1. 86 ± 0. 53） L/s],FEF 75% [（0. 95 ± 0. 48） L/s],FEF50% [（1. 99 ± 0. 83） L/s],FEF 25% [（3. 42 ± 0. 68） L/s] in observation group were significantly higher than those in control group（P〈0.05）. However the serum levels of CRP,IL-6,PCT in observation group were significantly lower than those in control group（P〈0.05）. Conclusion The ofazithromycin combined with glucocorticoid has obvious therapeutic effects on lobar pneumonia in children,which can effectively improve the serm levels of CRP,IL-6 and PCT.