红霉素和阿奇霉素对肺炎支原体感染儿童血清应激指标水平以及肺功能的影响

Effect of erythromycin and azithromycin on serum stress indicators and pulmonary function in children with MP-IgM positive mycoplasma pneumoniae infection

目的比较分析红霉素和阿奇霉素对血清MP-IgM阳性肺炎支原体感染儿童血清应激指标水平以及肺功能的影响。方法选取100例MP-IgM阳性肺炎支原体肺炎患儿作为研究对象,随机分为两组:红霉素组(n=47)与阿奇霉素组(n=53)。两组均给予常规治疗基础,红霉素组使用红霉素,阿奇霉素组使用阿奇霉素,进行抗感染治疗,观察两组患儿治疗前后的临床症状变化,比较两组患儿治疗前后的临床总有效率、不良反应发生情况、血清应激指标水平和肺功能指标的差异。结果阿奇霉素组治疗的总有效率为98.11%,显著高于红霉素组(85.11%),差异有统计学意义(P<0.05);治疗后阿奇霉素组的血清应激指标Th1/Th2、IFN-γ以及IFN-γ/IL-4均显著低于对照组,肺功能指标最大呼气中段流量(MMF)、峰流速(PEF)、最大吸气压(PImax)及最大呼气压(PEmax)均明显高于红霉素组,差异有统计学意义(P<0.05),两组的不良反应发生率没有明显的差异(P>0.05)。结论阿奇霉素治疗血清MP-IgM阳性肺炎支原体感染儿童的疗效、对机体免疫应激反应与肺功能的改善作用方面均优于红霉素,这与其在炎症细胞内能达到高浓度来清除肺炎支原体有关。

Objective To compare and analyze the effect of erythromycin and azithromycin on serum stress index and pulmonary function in children with MP-IgM positive Mycoplasma pneumoniae infection.Methods 100 MP-IgM positive children with Mycoplasma pneumoniae pneumonia admitted to our hospital from June 2016 to May 2019 were randomLy divided into two groups:the erythromycin group(n=47)and the azithromycin group(n=53).On the basis of routine treatment,the erythromycin group was treated with erythromycin and the azithromycin group was treated with azithromycin for anti-infection.The changes of clinical symptoms before and after treatment were observed.The differences in indicators including total clinical effective rate,adverse reactions,serum stress index level and pulmonary function were compared between the two groups before and after treatment.Results The total effective rate of the azithromycin group was 98.11%,which was significantly higher than 85.11%of the erythromycin group(P<0.05).After treatment,the serum stress indicators Th1/Th2,IFN-γand IFN-γ/IL-4 in the azithromycin group were significantly lower than those in the erythromycin group,and the function indicators,including maximum expiratory flow(MMF),peak expiratory flow(PEF),maximum inspiratory pressure(PImax),and maximum expiratory pressure(PEmax)were significantly higher than those in the erythromycin group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Azithromycin is superior to erythromycin in treatment of MP-IgM positive children with Mycoplasma pneumoniae infection in terms of total efficacy,improvement of immune stress response and pulmonary function,which is related to the high concentration of azithromycin in inflammatory cells to clear Mycoplasma pneumoniae.