重症支原体肺炎采用不同剂量糖皮质激素治疗的应用效果观察

Observation on the Effect of Different Doses of Glucocorticoid in the Treatment of Severe Mycoplasma Pneumonia

目的探究重症支原体肺炎采用不同剂量糖皮质激素治疗的应用效果。方法选取我院2016年4月—2017年3月收治的重症支原体肺炎患者90例作为研究对象。根据随机表法,将其分为两组。对照组采用低剂量的糖皮质激素治疗[1~2 mg/(kg·d)注射用甲泼尼龙琥珀酸钠(甲强龙)];治疗组采用高剂量的糖皮质激素治疗[10~20mg/(kg·d)甲强龙]。治疗3天,比较两组患者重症支原体肺炎缓解率;咳嗽缓解、体温恢复、肺部X线阴影消失、住院时间;药物安全性。结果治疗组患者重症支原体肺炎缓解率高于对照组,差异具有统计学意义(P<0.05)。对照组缓解率80.00%,完全缓解20例,部分缓解16例;治疗组缓解率95.56%,完全缓解32例,部分缓解11例。治疗组咳嗽缓解、体温恢复、肺部X线阴影消失、住院时间短于对照组,差异具有统计学意义(P<0.05);治疗组药物安全性与对照组对比,差异无统计学意义(P>0.05)。结论重症支原体肺炎采用不同剂量糖皮质激素治疗的应用效果存在差异,高剂量应用效果更好,可缩短疗程,加速康复,且不增加副作用,安全性高。

Objective To explore the severe mycoplasma pneumonia with different dosage and application effect of glucocorticoid treatment. Methods 90 cases patients with severe mycoplasma pneumonia from April 2016 and March 2017 were selected as the study objects. According to the random table, they were divided into two groups. The control group was treated with a low dose of glucocorticoid for the treatment [1~2 mg/（kg·d） methylprednisolone sodium succinate for injection]. The treatment group was treated with a high dose of glucocorticoid for [10 ~ 20 mg/（kg·d） methylprednisolone sodium succinate for injection]. On the 3 day of treatment, the relief rates of severe mycoplasma pneumonia in two groups were compared, including cough alleviation, body temperature recovery, lung X-ray shadow disappearance, hospitalization time, and drug safety. Results The remission rate of severe mycoplasma pneumonia in the treatment group was higher than that in the control group, and the difference was statistically significant（P〈 0.05）. In the control group, the remission rate was 80.00%, the total remission was 20 cases, and the partial remission was 16 cases. The remission rate of the treatment group was 95.56%, complete remission in 32 cases, and partial remission in 11 cases. In the treatment group, the cough relief, the body temperature recovery, the lung X ray shadow disappeared and the hospitalization time were shorter than the control group, the difference was statistically significant（P 〈0.05）. The difference of drug safety in the treatment group was not statistically significant compared with the control group（P 〉0.05）. Conclusion The application effect of different doses of corticosteroids in severe mycoplasma pneumoniae is different. High dose application is better, which can shorten the course of treatment and accelerate recovery, without increasing side effects and high safety.