甲基强的松龙联合阿奇霉素治疗小儿难治性支原体肺炎疗效观察

Methylprednisolone combined with azithromycin in treatment of refractory mycoplasmal pneumonia in children

目的:探讨甲基强的松龙联合阿奇霉素治疗儿童难治性肺炎支原体肺炎的临床疗效和不良反应。方法:选择某院收治难治性支原体肺炎患儿共106例,根据随机数字表法随机分为观察组对照组,每组各53例。对照组患儿给予阿奇霉素治疗,观察组患儿在治疗组的基础上加用甲基强的松龙(2 mg/kg),比较2组患儿咳嗽好转时间、体温恢复正常时间、住院时间、肺部啰音消失时间、炎症因子改善情况及胃肠道等不良反应发生情况。结果:治疗后,观察组的总有效率明显高于对照组,差异有统计学意义(P<0.05);观察组患儿的咳嗽好转时间、体温正常时间、总住院时间、肺部啰音消失时间均显著短于对照组,差异有统计学意义(P<0.05);治疗7d后观察组的炎症因子(CRP,IL-6,IL-10,TNF-α)数值较对照组均有不同程度降低,2组比较差异有统计学意义(P<0.05);药物不良反应对照组6例,观察组8例,2组比较差异无统计学意义(P>0.05)。结论:糖皮质激素甲基强的松龙联合阿奇霉素临床治疗儿童难治性肺炎支原体肺炎具有良好的治疗效果,且药物副反应较小,值得临床推广应用。

Objective： To explore the clinical efficacy and side effects of azithromycin combined with intravenous methylprednisolone and intravenous azithromycin in the treatment of children with refractory mycoplasmal pneumonia（ MP）.Methods： 106 children with refractory MP were randomly divided into an observation group and a control group,with 53 cases in each. The children in the control group were treated with azithromycin,and the children in the observation group were treated with methylprednisolone（ 2 mg/Kg） on the basis of the treatment group. The cough improvement time,the normal body temperature recovery time,the time of hospitalization,the disappearance time of lung rale,the improvement of inflammatory factors and the occurrence of adverse reactions in the gastrointestinal tract were compared between the two groups. Results： After the treatment,the total effective rate of the observation group was significantly higher than that of the control group（ P〈0.05）.The cough improvement time,the normal body temperature recovery time,the total hospitalization time and the disappearance time of lung rale in the observation group were significantly shorter than those in the control group（ P〈0.05）. 7 days after the treatment,the inflammatory factors（ CRP,IL-6,IL-10,TNF-alpha） of the observation group became lower than those of the control group,and the difference was statistically significant（ P〈0.05）. 6 cases of drug side reaction occurred in the control group and 8 in the observation group,with no statistical difference（ P〈0. 05）. Conclusion： Combination of glucocorticoid methylprednisolone and azithromycin in treatment of MP in children has good therapeutic effect and little side effects. It is worthy of clinical application.