冲击剂量甲泼尼龙琥珀酸钠联合常规治疗对小儿重症支原体肺炎治疗效果及安全性观察

Therapeutic effect and safety of shock dose of methylprednisolone sodium succinate combined with conventional therapy on children with severe mycoplasmal pneumonia

目的:分析冲击剂量甲泼尼龙琥珀酸钠联合常规治疗对小儿重症支原体肺炎治疗效果及安全性。方法:选取2017年8月至2019年8月收治的34例重症支原体肺炎患儿,随机分为观察组和对照组两组,均进行基础治疗;观察组患者用冲击剂量甲泼尼龙琥珀酸钠20 mg/(kg·d)治疗,对照组患者按常规剂量应用甲泼尼龙琥珀酸钠治疗,比较两组患者的临床疗效,临床症状缓解时间,治疗前、后CRP及免疫球蛋白水平。结果:观察组患者的临床疗效总有效率为94.41%,高于对照组患者的64.71%(P<0.05);观察组患者的退热时间、咳嗽缓解时间、肺部啰音消失时间、胸片恢复时间较对照组缩短(P<0.05);治疗前两组患者的CRP、免疫球蛋白水平比较,差异无统计学意义(P>0.05);治疗后两组患者的CRP水平下降(P<0.05),IgA、IgG、IgM水平提高(P<0.05),且观察组患者的CRP水平下降、免疫球蛋白水平上升更多(P<0.05);观察组、对照组患者的不良反应发生率分别为8.82%和5.88%,组间相比,差异无统计学意义(P>0.05)。结论:冲击剂量甲泼尼龙琥珀酸钠20 mg/(kg·d)治疗小儿重症支原体肺炎可提高临床疗效,缩短临床症状缓解时间,提高患儿免疫功能,不良反应发生率未增加,安全性高,值得在临床上推广。

Objective:To investigate the effect and safety of shock dose of methylprednisolone sodium succinate combined with conventional therapy on children with severe mycoplasmalpneumonia.Methods:Select 68 children with severe mycoplasmal pneumonia admitted from August 2017 to August 2019 and divide them into groups A and B randomly.All patients were given basic treatment,group A was treated with shock dose of methylprednisolone sodium succinate and group B was treated with conventional dose of methylprednisolone sodium succinate.Compare clinical efficacy,time to clinical symptom relief,CRP and immunoglobulin levels before and after treatment.Results:The total effective rate was94.41%in group A compared with64.71%in group B(P<0.05).The time of fever in group A,time to relieve cough,time to disappear of lung voice,and recovery time of chest radiograph were significantly higher than those in group B.Shorted(P<0.05),there was no significant difference in CRP and immunoglobulin levels between the two groups before treatment(P>0.05).After treatment,CRP levels were significantly decreased,IgA,IgG,IgM levels were significantly increased.The level of immunoglobulin decreased more significantly(P<0.05).The incidence of adverse reactions in group A and B were 17.65%、11.76%,respectively,and the difference was not statistically significant(P>0.05).Conclusion:Impact dose(20 mg/kg/d)methylprednisolone sodium succinate for the treatment of severe mycoplasmal pneumonia in children can improve clinical efficacy,shorten the time of clinical symptom relief,improve the immune function of children,increase the incidence of adverse reactions,and has high safety.It is recommended to be clinically popularized.