小剂量阿奇霉素联合孟鲁司特钠治疗小儿反复下呼吸道感染疗效观察

Therapeutic effect of low-dose azithromycin combined with montelukast sodium on children with recurrent lower respiratory tract infection

目的观察小剂量阿奇霉素联合孟鲁司特钠治疗小儿反复下呼吸道感染的临床疗效。方法选取淮北市人民医院儿科2017年1月-2018年12月收治的80例诊断为细菌性肺炎的反复下呼吸道感染患儿作为RLRTI组,根据口服阿奇霉素剂量的不同分为小剂量组和正常剂量组各40例,与同期诊断细菌性肺炎的初次住院患儿40例(对照组)进行比较,其中小剂量组在对照组基础上加用5 mg/kg阿奇霉素和孟鲁司特钠颗粒4 mg口服;正常剂量组在对照组基础上加用10 mg/kg阿奇霉素和孟鲁司特钠颗粒4 mg口服;统计3组患儿的实验室检查数据,所有患儿数据纳入Excel数据库中进行统计,采用SPSS 22.0统计学软件进行统计学分析,观察患儿的临床症状、体征及预后。结果 RLRTI组和对照组在入院时嗜酸性粒细胞(EOS)和总免疫球蛋白E(IgE)比较差异有统计学意义(P<0.05),经过治疗后2组患儿白细胞(WBC)、中性粒细胞(N)、超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、总IgE及住院天数比较差异有统计学意义(均P<0.05),EOS差异无统计学意义(P>0.05),3组患儿治疗总有效率比较差异有统计学意义(χ~2=18.813,P<0.001);小剂量组和正常剂量组总不良反应发生率比较差异有统计学意义(χ~2=16.241,P<0.001);3组患儿出院后总复发率比较差异有统计学意义(χ~2=9.279,P=0.010)。结论小剂量阿奇霉素联合孟鲁司特钠可以明显缩短RLRTI患儿的住院时间,降低患儿的不良反应发生率和复发率,减少患儿静脉抗生素使用时间和住院时间。

Objective To observe the clinical efficacy of low-dose azithromycin combined with montelukast sodium in the treatment of recurrent lower respiration tract infection(RLRTI) in children. Methods Total 80 children with recurrent lower respiratory tract infection diagnosed as bacterial pneumonia admitted to the Department of Pediatrics of Huaibei People’s Hospital from January 2017 to December 2018 were selected as the RLRTI group. They were divided into low-dose group and normal dose group according to the dose of oral azithromycin, 40 patients in each group. Forty children diagnosed with bacterial pneumonia in the same period were selected as control group. The low-dose group was given 5 mg/kg azithromycin and 4 mg of montelukast sodium granules on the basis of the control group. The normal dose group was treated with 10 mg/kg azithromycin and montelukast sodium granules 4 mg orally. The laboratory data of the three groups were counted. All the children’s data were included in the Excel database for statistical analysis. SPSS 22.0 software was used. Statistical analysis was performed to observe the clinical symptoms, signs and prognosis of the children. Results At admission, there was a statistically significant difference in eosinophils(EOS) and total IgE between the RLRTI group and the control group(all P<0.05). After treatment, the differences in white blood cell(WBC), neutrophil(N), hypersensitive C-reactive protein(hs-CRP), procalcitonin(PCT), total IgE and hospitalization between the two groups were statistical significance(all P<0.05), and there was no significant difference in EOS(P>0.05). There was significant difference in the total effective cases between the three groups(χ~2=18.813, P<0.001). There was a statistically significant difference in total adverse reactions between the low-dose group and the normal dose group(χ~2=16.241, P<0.001). There was a statistically significant difference in the number of total recurrences after discharge from the three groups(χ~2=9.279, P=0.010). Conclusion Low-dose azithromycin combined with montelukast sodium can significantly shorten the length of hospital stay in children with RLRTI, reduce the adverse reactions and recurrence rate of children, and reduce the time of intravenous antibiotic use and the number of hospitalizations.