阿奇霉素序贯疗法联合复可托治疗小儿肺炎支原体感染的疗效观察

Clinical observation of Azithromycin sequential therapy combined with Fucotto in the treatment of Mycoplasma pneumoniae infection in children

目的分析阿奇霉素序贯疗法联合复可托对小儿肺炎支原体(MP)感染的疗效及血清谷胱甘肽过氧化物酶(GSH-Px)、细胞间黏附分子-1(ICAM-1)水平的影响。方法选取2017年4月至2018年5月来该院儿科就诊并被确诊为小儿MP感染的患儿共计100例作为研究对象,将其平均分为观察组和对照组。对照组患儿采用阿奇霉素序贯疗法,观察组患儿在对照组基础上联合使用复可托。比较两组患儿的临床疗效及不良反应发生率、免疫学指标及肺功能指标。结果经治疗后,观察组患儿的总有效率为94.0%,对照组总有效率为80.0%,差异有统计学意义(P<0.05)。疗程结束后,观察组患儿的不良反应发生率(8.0%)显著低于对照组(22.0%),差异有统计学意义(P<0.05)。治疗前两组患儿血清中炎症因子水平比较差异无统计学意义(P>0.05),经治疗后,两组患儿血清中的ICAM-1、白细胞介素(IL)-5、IL-6及IL-10水平均出现不同程度地降低,但是观察组的下降幅度与对照组相比更为显著,差异有统计学意义(P<0.05)。在治疗前,观察组和对照组患儿血清中氧化/抗氧化指标水平比较,差异无统计学意义(P>0.05),治疗后两组患儿血清中的GSH-Px和超氧化物歧化酶(SOD)水平与治疗前比较均明显升高,丙二醛(MDA)则出现显著性下降,但是观察组与对照组相比下降更为明显,差异有统计学意义(P<0.05)。治疗后两组患儿的第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、呼气峰流速(PEF)和用力肺活量25%、50%、75%时对应的呼气峰流速FEF25、FEF50、FEF75都出现好转恢复,但是观察组相比于对照组恢复更为显著,差异有统计学意义(P<0.05),但治疗前观察组和对照组患儿肺功能指标比较,差异无统计学意义(P>0.05)。结论阿奇霉素序贯疗法联合复可托对小儿MP感染治疗有效。

Objective To study the effect of azithromycin sequential therapy combined with fucotto on Mycoplasma pneumoniae(MP)infection in children and the level of serum glutathione peroxidase(GSH-Px)and intercellular adhesion molecules-1(ICAM-1).Methods A total of 100 children with MP infection in a hospital from April 2017 to May 2018 were selected as the study subjects,and divided into observation group and control group on average.The patients in the control group were treated with azithromycin sequential therapy,while the patients in the observation group were combined with fucotto on the basis of the control group.The clinical efficacy,incidence of adverse reactions,immunological and pulmonary function indexes were compared between the two groups.Results After treatment,the total effective rate of the observation group was 94.0%,but the total effective rate of the control group was 80.0%.There was a significant difference between the two groups(P<0.05).At the end of the course of treatment,the incidence of adverse reactions in the observation group was 8.0%,which was significantly lower than that in the control group(22.0%).There was a significant difference between the two groups(P<0.05).Before treatment,there was no significant difference in the levels of inflammatory factors in serum between the two groups(P>0.05).After treatment,the levels of ICAM-1,IL-5,IL-6 and IL-10 in the serum of the two groups decreased in varying degrees,but the decrease in the observation group was more significant than that in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in serum oxidation/antioxidant indexes between the observation group and the control group(P>0.05).After treatment,the levels of GSH-Px and SOD in the serum of the two groups increased significantly compared with before treatment,while the levels of MDA decreased significantly.However,the decrease in the observation group was more obvious than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the indexes of FEV1,PEF,FVC,FEF25,FEF50 and FEF75 of the two groups improved,but the recovery of the observation group was more significant than that of the control group(P<0.05),but before treatment,there was no significant difference in the indexes of pulmonary function between the observation group and the control group(P>0.05).Conclusion Azithromycin sequential therapy combined with fucotto is effective in the treatment of MP infection in children.