糖皮质激素联合阿奇霉素治疗小儿重症支原体肺炎效果分析

Effect analysis of glucocorticoid combined with azithromycin in the treatment of children with severe mycoplasma pneumonia

目的：探讨糖皮质激素联合阿奇霉素治疗小儿重症支原体肺炎的临床效果。方法：收治重症支原体肺炎患儿80例，随机分成观察组和对照组各40例，对照组用阿奇霉素10mg/(kg·d)+5%葡萄糖注射液配置成1%浓度静脉滴注，治疗7d后，改为口服，剂量10mg/(kg·d)，连用5d。观察组在对照组的基础上增加甲强龙1～2mg/(kg·d)静脉滴注，治疗3d后，改口服强的松1mg/(kg·d)，渐减量至停用，总疗程7～10d。结果：观察组发热消失时间(3.9±1.7)d，肺部啰音消失时间(4.2±1.7)d，咳嗽消失时间(4.6±2.1)d；对照组发热消失时间(5.7±1.9)d，肺部啰音消失时间(6.8±1.9)d，咳嗽消失时间(8.5±3.6)d，两组比较，差异有统计学意义(P＜0.05)。观察组总有效率95.0%，治疗3个月复发1例，复发率2.5%；对照组总有效率77.5%，治疗3个月复发10例，复发率25%，两组比较，差异有统计学意义(P＜0.05)。结论：糖皮质激素联合阿奇霉素治疗小儿重症支原体肺炎效果显著。

Objective:To explore the clinical effect of glucocorticoid combined with azithromycin in the treatment of children withsevere mycoplasma pneumonia.Methods:80 children with severe mycoplasma pneumonia were selected.They were randomlydivided into the observation group and the control group with 40 cases in each.The control group was given azithromycin 10 mg/(kg·d) and 5% glucose injection configured 1% concentration for intravenous infusion,after 7 days of treatment,it was changed tooral,and the dose was 10 mg/(kg · d),for 5 days.On the basis of the control group,the observation group was givenmethylprednisolone 1～2 mg/(kg·d) for intravenous infusion,after 3 days of treatment,it was changed to oral methylprednisolone 1mg/(kg·d),gradually reduced to stop,and the total course was 7 to 10 days.Results:In the observation group,the disappearance timeof fever was (3.9±1.7)days;the disappearance time of lung rale was (4.2±1.7)days;the disappearance time of cough was (4.6±2.1)days.In the control group,the disappearance time of fever was (5.7±1.9)days;the disappearance time of lung rale was (6.8±1.9)days;the disappearance time of cough was (8.5±3.6)days.The difference between groups was statistically significant(P<0.05).In the observation group,the total effective rate was 95%;1 case was recidivation after 3 months of treatment;the recurrence ratewas 2.5% .In the control group,the total effective rate was 77.5% ;10 cases were recidivation after 3 months of treatment;therecurrence rate was 25% .The difference between groups was statistically significant(P<0.05).Conclusion:The effect ofglucocorticoid combined with azithromycin in the treatment of children with severe mycoplasma pneumonia is significant.