阿奇霉素和穿心莲内酯磺化物的联合应用对肺炎支原体肺炎患儿临床疗效和血清炎症因子的影响

The Combined Effect of Andrographolide Sulfonated Injection and Azithromycin on Serum Inflammatory Factors and Its Clinical Effect on Pediatric Mycoplasma Pneumonia

目的:探讨穿心莲内酯磺化物(ADS)与阿奇霉素的联合应用对肺炎支原体肺炎(MPP)患儿临床疗效和血清炎症因子的影响。方法:将100例MPP患儿随机分为试验组和对照组,试验组给予ADS联合阿奇霉素静滴治疗,对照组只给予同等剂量阿奇霉素静滴治疗;检测试验组和对照组患儿治疗前(t0)、治疗后24小时(t1)及治疗后7天(t2)血清肿瘤坏死因子-α(TNF-α)和白介素-17(IL-17)的浓度,并进行对比分析,同时比较患儿临床症状包括发热、咳嗽等的转归。结果:试验组住院时间、发热持续时间、湿啰音消失时间及咳嗽持续时间和对照组相比均缩短(P<0.05);t1与t0相比,试验组患儿血清TNF-α和IL-17下降(P<0.05),对照组患儿血清TNF-α和IL-17无显著差异(P>0.05),试验组较对照组改善更明显(P<0.05);t2与t0相比,试验组和对照组患儿血清TNF-α和IL-17均下降(P<0.05),试验组较对照组改善更明显(P<0.05)。结论:ADS与阿奇霉素联合治疗MPP,可以提高MPP的疗效;其机制可能与改变机体的细胞因子水平、调节免疫功能有关;且ADS能显著下调MPP治疗早期炎症因子水平。

Objective： To discuss the combined effect of andrographolide sulfonated（ ADS） injection and azithromycin on serum inflammatory factors and its clinical effect on pediatric mycoplasma pneumonia（ MPP）. Methods： 100 cases of hospitalized MPP children were selected and randomly divided into two groups. Intravenous azithromycin combined with intravenous ADS was administered to the experimental group and the control group was given equal doses of azithromycin. Serum content of TNF-α and IL-17 of the two groups were tested before initiating the treatment（ t0）,24 h after initiating the treatment（ t1） and 7 days after treatment（ t2）. Results： The length of hospital stay,fever duration time,rales disappearance time,cough disappearance time in experimental group were all significantly less than that in control group（ P 〈 0. 05）. Compared with t0,the serum TNF-α and IL-17 level at t1 appeared to be significantly decreased in the experimental group（ P 〈 0. 05） whereas the serum TNF-α and IL-17 level at t1 in the control group was not significant different（ P 〉0. 05）. The difference between two groups was significant（ P 〈 0. 05）. Compared with t0,The serum TNF-α and IL-17 level of the two groups at time of t2 were all decreased and the defferences were significant（ P 〈 0. 05）. The decrease of the serum TNF-a and IL-17 level from t0 to t2 of experimental group was more than that of the control group（ P 〈 0. 05）. Conclusion： Intravenous azithromycin combined with intravenous ADS may be able to improve therapeutic effect on MPP; its mechanism may be the change in cytokines level and immune function regulation. Also,ADS in treating pediatric mycoplasma pneumonia exhibit significant adjustment on inflammatory factors level,especially in the early stage of the treatment.