甲泼尼龙联合阿奇霉素治疗小儿难治性支原体肺炎的疗效及其对相关实验室指标的影响

Intravenous Methylprednisolone Combined with Azithromycin in Treatment of Children with Refractory Mycoplasma Pneumonia and Influence on Relevant Laboratory Parameters

目的:探讨静脉滴注甲泼尼龙联合阿奇霉素治疗小儿难治性支原体肺炎的疗效及其对相关实验室指标的影响。方法:选择2014年6月至2015年12月我院收治的难治性支原体肺炎患儿106例,依据随机数字表法分为观察组和对照组各53例。对照组给予阿奇霉素治疗,观察组在对照组治疗基础上静脉滴注甲泼尼龙,两组患儿疗程均为5 d,比较两组患儿临床疗效、症状和体征消退时间、药物不良反应及治疗前后血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、D-二聚体水平。结果:观察组患儿治疗总有效率为96.23%,高于对照组的79.25%(P<0.05);观察组咳嗽缓解时间、退热时间及肺部阴影消退时间均明显短于对照组(P<0.05);两组患儿血清CRP、TNF-α、D-二聚体水平治疗后明显降低(P<0.05);观察组血清CRP、TNF-α、D-二聚体水平治疗后低于对照组(P<0.05);两组患儿不良反应发生率比较差异无统计学意义(P>0.05)。结论:静脉滴注甲泼尼龙联合阿奇霉素治疗小儿难治性支原体肺炎疗效显著,安全性好,其作用机制可能与降低CRP、TNF-α、D-二聚体水平有关。

Objective：To investigate intravenous methylprednisolone combined with azithromycin in treatment of children with refractory Mycoplasma pneumonia and the influence on relevant laboratory parameters.Methods：One hundred and six children with refractory Mycoplasma pneumonia in our hospital from June 2014 to December 2015 were selected.All children were randomly divided into observation group（53 cases） and control group（53 cases）.The control group was given azithromycin,the observation group on the basis of the control group was given intravenous methylprednisolone.The treatment course of the two groups were all 5 day.The treatment efficacy,symptoms,signs of regression time,the levels of serum CRP,TNF-α,D-dimer and adverse drug reaction during the period of drug use before and after treatment were compared between the two groups.Results：The total effective rate（96.23%） in the observation group was higher than that of the control group（79.25%,P〈0.05）.The cough relief time,pyretolysis time and lung shadow fading time of observation group were significantly shorter than those of the control group（P〈0.05）.The serum levels of CRP,TNF-α,D-dimer significantly decreased after treatment in two groups（P〈0.05）.The serum levels of CRP,TNF-α,D-dimer in the observation group after treatment were lower than the control group（P〈0.05）.There was no significant difference in the incidence of adverse reactions between the two groups（P〈0.05）.Conclusion：Intravenous methylprednisolone combined with azithromycin treatment in refractory Mycoplasma pneumonia in children has a significant efficacy,and its mechanism may be associated with decreased CRP,TNF-α,D-dimer levels,and security is good.