红霉素、阿奇霉素序贯治疗儿童肺炎支原体肺炎有效性和安全性的临床研究

Clinical study on the efficacy and safety of erythromycin and azithromycin in the treatment of Mycoplasma pneumoniae pneumonia in children

目的探讨红霉素、阿奇霉素序贯治疗儿童肺炎支原体肺炎有效性和安全性。方法采用前瞻性、随机、对照研究方法,将2016年5月~2017年5月在本院接受治疗的124例肺炎支原体肺炎患儿按照随机数字表法分为序贯组62例和对照组62例,序贯组先静脉滴注红霉素,20~30 mg/(kg·d),分2次给药,连续滴注5 d,后改用口服阿奇霉素,10 mg/kg,1次/d,连续用5 d;对照组口服阿奇霉素,10 mg/kg,1次/d,连续用药5 d,停药2 d,再继续口服阿奇霉素10 mg/kg,1次/d,连续用药3 d,两组疗程均为10 d。然后,比较两组患儿治疗有效率、临床症状持续时间和症状改善率,并记录患儿治疗期间不良反应发生率。结果本研究实际收集有效病例121例,其中序贯组61例,对照组60例。序贯组总有效率为96.7%,对照组总有效率为88.3%,序贯组总有效率显著高于对照组(P<0.05);序贯组在咳嗽、喘息、湿啰音、呼吸困难等临床指标消失时间和住院时间方面均少于对照组(P均<0.05);序贯组总不良反应发生率为13.1%(8/61),对照组为8.3%(5/60),两组患儿总不良反应发生率比较差异无统计学意义(X^2=1.069,P=0.301)。结论红霉素、阿奇霉素序贯疗法能够显著提高肺炎支原体肺炎临床疗效,缩短临床症状消失时间,而且安全性高。

Objective To investigate the efficacy and safety of erythromycin and azithromycin in the sequential treatment of Mycoplasma pneumoniae pneumonia in children. Methods A prospective, randomized, controlled study method, 124 cases of children with mycoplasma pneumonia from May 2016 to May 2017 in my hospital were randomly divided into sequential group 62 cases and control group 62 cases, group sequential intravenous infusion of erythromycin, 20-30 mg/(kg · d), 2 delivery, continuous infusion of 5 d after oral azithromycin, 10 mg/kg, 1 times/d, continuous use of 5 d; the control group of oral azithromycin, 10 mg/kg, 1 times/d, continuous medication 5 d, discontinuation of 2 d, and then continue to oral azithromycin 10 mg/kg, 1 times/d, 3 d two groups of continuous medication, course of treatment was 10 days. Then, the treatment efficiency, the duration of clinical symptoms and the rate of symptom improvement were compared between the two groups, and the incidence of adverse reactions during the treatment of the children was recorded. Results In this study, 121 cases of effective cases were collected, including 61 cases in sequential group and 60 cases in control group. The total efficiency of the sequential group was 96.7%, control group total effective rate was 88.3%, the total efficiency of the sequential group was significantly higher than the control group(P<0.05); sequential group in coughing, wheezing, rales, dyspnea and other clinical indicators disappear time and hospital stay were lower than the control group(P<0.05); sequential group the total incidence of adverse reaction was 13.1%(8/61), the control group was 8.3%(5/60), the total adverse reaction in two groups were no significant differences(X^2=1.069, P=0.301). Conclusion Sequential therapy of erythromycin and azithromycin can significantly improve the clinical efficacy of Mycoplasma pneumoniae pneumonia, shorten The time of clinical symptom disappearance, and has high safety.