阿奇霉素注射剂联合利巴韦林注射液治疗小儿病毒性肺炎的临床研究

Clinical trial of azithromycin injection combined with ribavirin injection in the treatment of children with viral pneumonia

目的观察阿奇霉素注射剂联合利巴韦林注射液治疗小儿病毒性肺炎的临床疗效及安全性。方法将74例病毒性肺炎患儿随机分为对照组和试验组,每组37例。对照组予以利巴韦林每次10 mg·kg-1,bid,静脉滴注;试验组在对照组治疗的基础上,予以阿奇霉素每次0.125 g,bid,静脉滴注。2组患儿均治疗7 d。比较2组患儿的临床疗效,肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、IL^(-1)7和IL-23水平,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为89.19%(33例/37例)和62.16%(23例/37例),差异有统计学意义(P<0.05)。治疗后,试验组和对照组的TNF-α分别为(27.69±2.47)和(34.32±2.88)ng·L^(-1),IL-8分别为(1.11±0.04)和(1.98±0.14)ng·L^(-1),IL-17分别为(30.99±2.88)和(44.08±4.16)ng·L^(-1),IL-23分别为(35.02±3.91)和(47.79±5.57)ng·L^(-1),差异均有统计学意义(均P<0.05)。试验组的药物不良反应主要有关节和神经肌肉疼痛、腹泻和恶心,对照组的药物不良反应主要有腹泻、眩晕和头痛。试验组和对照组的总药物不良反应发生率分别为13.51%和16.22%,差异无统计学意义(P>0.05)。结论阿奇霉素注射剂联合利巴韦林注射液治疗小儿病毒性肺炎的临床疗效确切,其能显著改善血清中TNF-α、IL-8、IL-17和IL-23水平,且不增加药物不良反应的发生率。

Objective To observe the clinical efficacy and safety of azithromycin injection combined with ribavirin injection in the treatment of children with viral pneumonia. Methods A total of 74 children with viral pneumonia were randomly divided into control and treatment groups with 37 cases per group. Control group was given ribavirin 10 mg·kg-1 per time,bid,intravenous drip. Treatment group received azithromycin0. 125 g per time,bid,intravenous drip,on the basis of control group.Two groups were treated for 7 d. The clinical efficacy,level of tumor necrosis factor-α（ TNF-α）,interleukin-8（ IL-8）,IL^（-1）7 and IL-23,and adverse drug reactions were compared between two groups.Results After treatment,the total effective rates of treatment and control groups were 89. 19%（ 33 cases/37 cases） and 62. 16%（ 23 cases/37 cases） with significant difference（ P 0. 05）. After treatment,the main indexes of treatment and control groups were compared： TNF-α were（ 27. 69 ± 2. 47） and（ 34. 32 ± 2. 88） ng·L^（-1）,IL-8 were（ 1. 11 ± 0. 04） and（ 1. 98 ± 0. 14） ng·L^（-1）,IL-17 were（ 30. 99 ± 2. 88） and（ 44. 08 ± 4. 16） ng·L^（-1）,IL-23 were（ 35. 02 ± 3. 91） and（ 47. 79 ± 5. 57） ng·L^（-1）,the differences were statistically significant（ all P 0. 05）. The adverse drug reactions of treatment group were pain of joint and neuromuscular,diarrhea and nausea,which in control group were diarrhea,dizziness and headache. The total incidences of adverse drug reactions in treatment and control groups were 13. 51% and 16. 22% without significant difference（ P 0. 05）. Conclusion Azithromycin injection combined with ribavirin injection has a definitive clinical efficacy in the treatment of children with viral pneumonia,which can improve the levels of TNF-α,IL-8,IL-17 and IL-23,without increasing the increasing of adverse drug reactions.