乳酸红霉素联合阿奇霉素治疗过敏性紫癜的临床疗效及OPN、NF-κB水平变化研究

Clinical efficacy of erythromycin lactic acid combined with azithromycin in the treatment of allergic purpura and changes of OPN and NF-κB levels

目的:探究乳酸红霉素联合阿奇霉素治疗过敏性紫癜的临床疗效及OPN、NF-κB水平变化.方法:2015年5月~2018年11月我院收治的80例肺炎支原体感染致过敏性紫癜患儿,根据随机数字法,分为观察组40例及对照组40例,两组均进行常规治疗,对照组口服阿奇霉素干混悬剂,观察组在此基础上加用乳酸红霉素,两组疗程均为14d.比较两组治疗效果及不良反应发生情况,分别于治疗前后抽取3mL静脉血,采用Elisa法检测两组治疗前后的骨桥蛋白(OPN)、核转录因子(NF-κB)及肿瘤坏死因子-α(TNF-α)、γ-干扰素(IFN-γ)、白介素-12 (IL-12)水平.结果:观察组的治疗总效率95.00%显著高于对照组的80.00%;治疗后,两组的OPN、NF-κB水平均下降,观察组显著低于对照组;治疗后,两组的TNF-α、IFN-γ、IL-12水平均下降,观察组显著低于对照组;两组不良反应发生率无显著差异.结论:乳酸红霉素联合阿奇霉素治疗过敏性紫癜的疗效显著,安全性高,OPN、NF-κB可能通过上调炎性因子水平参与过敏性紫癜的发生发展过程.

Objective To investigate the clinical efficacy of erythromycin lactic acid combined with azithromycin in the treatment of allergic purpura and the changes of OPN and NF-kB levels. Methods From May 2015 to November 2018, 80 children with allergic purpura caused by Mycoplasma pneumoniae infection in our hospital were divided into observation group 40 cases and control group 40 cases according to random number method. The two groups were treated with conventional treatment. The control group received oral azithromycin dry suspension, and the observation group added erythromycin lactic acid on the basis of the treatment. Both groups were treated for 14 days. Compare the therapeutic effects and adverse reactions between the two groups, and take 3mL venous blood before and after treatment. Elisa method was used to detect osteopontin (OPN), nuclear transcription factor (NF-kB) and tumor necrosis factor-α(TNF-α),γ-interferon (IFN-γ), and interleukin-12(IL-12) levels before and after treatment. Results The total treatment efficiency of the observation group was 95.00% significantly higher than that of the control group (80.00%). After treatment, the OPN and NF-kB levels in the two groups decreased, and the observation group was significantly lower than the control group. After treatment, the levels of TNF-α, IFN-γ and IL-12 decreased in the two groups, and the observation group was significantly lower than the control group. There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion Therapeutic effect of erythromycin lactic acid combined with azithromycin on allergic purpura is significant and safe. OPN and NF-κB may participate in the development of allergic purpura by up-regulating the level of inflammatory factors.