小剂量糖皮质激素治疗肺炎支原体肺炎并肺外并发症的临床疗效及安全性分析

Clinical efficacy and safety analysis of low dose glucocorticoid in the treatment of mycoplasma pneumoniae pneumonia complicated with extrapulmonary complications

目的探讨1 mg/(kg·d)小剂量与常规剂量糖皮质激素治疗肺炎支原体肺炎并肺外并发症的临床疗效及用药安全性。方法 140例肺炎支原体肺炎并肺外并发症患者,应用随机数字表法分成试验组与对照组,每组70例。两组患者均给予基础二联抗生素治疗,试验组在此基础上予以1 mg/(kg·d)小剂量糖皮质激素治疗,对照组予以2 mg/(kg·d)常规剂量糖皮质激素治疗。观察比较两组临床治疗效果、住院时间、症状与体征消失时间以及不良反应发生情况。结果试验组患者显效率为32.86%,低于对照组的50.00%,差异有统计学意义(P<0.05);两组患者总有效率比较差异无统计学意义(P>0.05)。两组患者症状及体征消失时间、住院时间比较差异无统计学意义(P>0.05)。试验组患者不良反应发生率为5.71%,明显低于对照组的24.29%,差异有统计学意义(P<0.05)。结论小剂量糖皮质激素治疗肺炎支原体肺炎并肺外并发症,疗效与常规剂量相当,且能够减少不良反应,安全可靠,更符合临床需求。

Objective To investigate the clinical efficacy and safety of 1 mg/（kg·d） low dose and conventional dose glucocorticoid in the treatment of mycoplasma pneumoniae pneumonia complicated with extrapulmonary complications. Methods A total of 140 patients with mycoplasma pneumoniae pneumonia complicated with extrapulmonary complications were divided into the experimental group and the control group according to the random number table method, 70 cases in each group. Patients of two groups were given basic two antibiotic treatment, and the experimental group was treated with 1 mg/（kg·d） low dose glucocorticoid on this basis. The control group was treated with 2 mg/（kg·d） conventional dose of glucocorticoid. The clinical efficacy, length of stay, symptoms and signs disappearance time and adverse reactions between the two groups were observed and compared. Results The effective rate of patients in the experimental group was 32.86%, which was significantly lower than 50.00% in the control group, the difference was statistically significant（P0.05）. There was no significant difference in the total effective rate between the two groups（P0.05）. There were no significant differences in symptoms and signs disappearance time and length of stay between the two groups（P0.05）. The incidence of adverse reactions in the experimental group was 5.71%, which was significantly lower than 24.29% in the control group, the difference was statistically significant（P0.05）. Conclusion The effect of small dose glucocorticoid in the treatment of mycoplasma pneumoniae pneumonia complicated with extrapulmonary complications is equal to the conventional dose, and it can reduce the adverse reactions. It is safe, reliable and more consistent with the clinical needs.