激素联合阿奇霉素对重症肺炎支原体肺炎患儿的疗效及对免疫功能的影响

Effect of Hormone Combined with Azithromycin on Children with Severe Mycoplasma Pneumoniae Pneumonia and its Effect on Immune Function

目的观察糖皮质激素联合阿奇霉素对重症肺炎支原体肺炎(SMPP)患儿的治疗效果,并分析其对患儿血清炎症因子和免疫功能的影响。方法回顾性分析2014年12月至2017年12月在我院接受治疗的SMPP患儿的临床资料,根据其治疗方式分为常规治疗组和联合治疗组。常规治疗组给予阿奇霉素治疗,联合治疗组在常规治疗的基础上给予糖皮质激素联合阿奇霉素治疗。观察两组患儿的治疗效果,比较两组患儿治疗前后血清炎症因子、免疫功能和肺功能指标的差异。结果联合治疗组治疗的有效率明显高于常规治疗组(χ~2=3.914,P=0.048);两组患儿治疗前炎症因子、免疫功能和肺功能水平无差别,治疗后,联合治疗组的IL-6、hs-CRP和TNF-α水平均低于常规治疗组,IgG、IgA、IgM、FVC、MMEF和PEF水平高于常规治疗组。结论糖皮质激素联合阿奇霉素对SMPP患儿有较好的治疗效果,可改善免疫功能,降低炎性反应水平,具有较好的临床应用价值。

Objective To observe the therapeutic effect of glucocorticoid combined with azithromycin on children with severe mycoplasma pneumoniae pneumonia( SMPP),and to analyze its effect on serum inflammatory factors and immune function in children.Methods The clinical data of children with SMPP who were treated in our hospital from December 2014 to December2017 were analyzed retrospectively and divided into routine treatment group and combined treatment group according to its treatment methods.Azithromycin was given to the routine treatment group,and the combined treatment group was treated with glucocorticoid combined with azithromycin on the basis of routine treatment.The therapeutic effects of the two groups were observed,and the differences of serum inflammatory factors,immune function and pulmonary function before and after treatment were compared between the two groups.Results The effective rate of the combined treatment group was significantly higher than that of the conventional treatment group(χ^2 value = 3.914,P = 0.048);There was no difference in inflammatory factors,immune function and pulmonary function between the two groups before treatment. After treatment,the levels of IL-6,hs-CRP and TNF-α in the combined treatment group were lower than those in the conventional treatment group,and the levels of Ig G,Ig A,Ig M,FVC,MMEF and PEF in the combined treatment group were higher than those in the conventional treatment group.Conclusion Glucocorticoid combined with azithromycin has a good therapeutic effect on children with SMPP,which can improve immune function,reduce the level of inflammatory reaction and has good clinical application value.