甲泼尼龙联合阿奇霉素治疗小儿重症支原体肺炎临床评价

Clinical Evaluation on Methylprednisolone Combined with Azithromycin in the Treatment of Children Patients with Severe Mycoplasma Pneumonia

目的探讨甲泼尼龙联合阿奇霉素治疗小儿重症支原体肺炎(MPP)的疗效及对患儿免疫功能及血清白细胞介素2(IL-2)和白细胞介素13(IL-13)水平的影响。方法选取医院2015年11月至2017年9月收治的重症MPP患儿78例,按治疗方法的不同分为对照组和研究组,各39例。两组患儿均在常规干预基础上使用阿奇霉素治疗,研究组患儿加用注射用甲泼尼龙琥珀酸钠,均治疗7 d。结果研究组总有效率为92. 31%,明显高于对照组的71. 79%(P <0. 05);治疗后,两组患儿血清IL-13及CD8+水平较治疗前明显降低,两组患儿治疗后的IL-2,CD_3^+,CD_4^+,CD_4^+/CD_8^+水平均较治疗前明显升高,且研究组均明显优于对照组(P <0. 05);两组不良反应发生率相当(15. 38%比10. 26%,P> 0. 05)。结论甲泼尼龙联合阿奇霉素治疗小儿重症MPP,可提高疗效,有效缓解临床症状,改善血清炎性因子水平及免疫功能,且不增加不良反应。

Objective To investigate the clinical effect of methylprednisolone combined with azithromycin in the treatment of children patients with severe mycoplasma pneumonia( MPP) and its effect on the immune function,the levels of serum interleukin-2( IL-2) and IL-13. Methods Totally 78 children patients with severe MPP admitted to our hospital from November 2015 to September 2017 were selected and divided into the control group and the study group,39 cases in each group. On the basis of routine intervention,the children patients in the two groups were treated with azithromycin,on this basis,the children patients in the study group were treated with Methylprednisolone Sodium Succinate for Injection. The treatment was continued for 7 d. Results The total effective rate of the study group was 92. 31%,which was significantly higher than 71. 79% of the control group( P < 0. 05). After treatment,the levels of serum IL-13 and CD8+in the two groups were lower than those before the treatment,while the levels of IL-2,CD3^+,CD4^+and CD4^+/CD8^+in the two groups were higher than those before treatment,and those in the study group were better than those in the control group( P < 0. 05).The incidence rate of adverse reactions in the two groups was similar( 15. 38% vs. 10. 26%,P > 0. 05). Conclusion Methylprednisolone combined with azithromycin in the treatment of children patients with severe MPP can improve the therapeutic effect,effectively alleviate clinical symptoms,improve the levels of serum inflammatory factors and immune function without increasing adverse reactions.