两种不同厂家阿奇霉素注射液治疗儿童肺炎支原体坏死性肺炎的疗效比较

Comparison of Two Different Manufacturers of Azithromycin in the Treatment of Children with Mycoplasma Pneumoniae Necrotizing Pneumonia

目的:比较两种阿奇霉素注射液(商品名分别为希舒美和其仙)联合纤维支气管镜肺泡灌洗术治疗儿童肺炎支原体坏死性肺炎的疗效,供临床参考。方法:收集2014年6月至2017年5月就诊于郑州儿童医院呼吸科的肺炎支原体坏死性肺炎患儿36例,根据治疗药物生产厂家的不同分为希舒美组和其仙组各18例。希舒美组应用进口阿奇霉素注射液(希舒美)联合纤维支气管镜肺泡灌洗术治疗,其仙组应用国产阿奇霉素注射液(其仙)联合纤维支气管镜肺泡灌洗术治疗,两组阿奇霉素用法用量和疗程相同,比较分析两组患儿的总有效率、需外科手术干预率、不良反应发生率、住院时间、发热缓解时间、咳嗽缓解时间及影像学好转时间等指标。结果:希舒美组的总有效率为94.44%,高于其仙组的61.11%;希舒美组需外科手术干预率为5.56%,低于其仙组的22.22%;希舒美组不良反应发生率为11.11%,低于其仙组的27.78%(P均<0.05)。两组咳嗽缓解时间、影像学好转时间比较差异无统计学意义(P>0.05),但希舒美组的发热缓解时间、住院时间短于其仙组(P<0.05)。结论:选用希舒美联合纤维支气管镜肺泡灌洗术治疗儿童肺炎支原体坏死性肺炎,可提高临床疗效,迅速缓解临床症状,减少手术干预可能及不良反应,缩短住院时间,值得临床推广应用。

Objective： To compare the efficacy of two different manufacturers of azithromycin injections（trade names： Xishumei and Qixian） combined with fiberoptic bronchoscopy and alveolar lavage in the treatment of children with Mycoplasma pneumoniae necrotizing pneumonia,so as to provide reference for the clinic. Methods： Thirty-six children with Mycoplasma pneumoniae necrotic pneumonia admitted into respiratory department of Children＇s Hospital of Zhengzhou from Jun. 2014 to May 2017 were enrolled to be divided into Xishumei group and Qixian group according to two different manufacturers,with 18 cases in each group. The Xishumei group was treated with imported azithromycin injection（ Xishumei） combined with fiberoptic bronchoscopy and alveolar lavage,the Qixian group was given domestic azithromycin injection（ Qixian） combined with fiberoptic bronchoscopy and alveolar lavage,the dosage and course of treatment were the same in both groups. The total effective rate,surgical intervention rate,incidence of adverse drug reactions（ ADR）,length of stay,relief time of fever,remission time of cough and improvement time of imaging were compared and analyzed. Results： The total effective rate was 94.44% in Xishumei group,which was higher than 61.11% in Qixian group; the surgical intervention rate of Xishumei group was 5.56%,which was lower than 22.22% in Qixian group; the incidence of ADR of Xishumei group was 11.11%,higher than that of control group 27. 78%（ P 0. 05）. There was no significant difference between two groups in remission time of cough and improvement time of imaging（ P0.05）,yet the relief time of fever and length of stay in Xishumei group were shorter than those in Qixian group（ P0.05）. Conclusion： Xishumei combined with fiberoptic bronchoscopy alveolar lavage in the treatment of children with Mycoplasma pneumoniae necrotizing pneumonia can improve the clinical efficacy,quickly relieve the clinical symptoms,reduce the surgical intervention and the occurrence of ADR,shorten the hospital stay and is worthy of clinical application.