阿奇霉素联合头孢曲松钠对小儿难治性肺炎支原体肺炎的效果及安全性系统评价

Effect and Safety of Azithromycin Combined with Ceftriaxone Sodium on Refractory Mycoplasmal Pneumonia in Children

目的评价阿奇霉素联合头孢曲松钠对小儿难治性肺炎支原体肺炎的效果及安全性。方法选取2017年2月—2018年11月收治的300例小儿难治性肺炎支原体肺炎患儿,随机分为参照组(阿奇霉素)和试验组(阿奇霉素联合头孢曲松钠)。观察两组的临床疗效。结果相对比参照组,试验组患儿咳嗽消失(3.33±0.26)d、退烧时间(3.85±1.52)d、肺啰音消失(5.66±2.14)d、喘息时间(3.52±0.54)d及住院时间(11.75±3.08)d明显缩短(t=24.038、5.663、9.526、12.609、17.567,P=0.000);两组患者的血清细胞因子水平比较,干预后试验组患儿白介素-6水平(15.56±10.43)pg/mL、白介素-8(10.66±6.29)pg/mL及肿瘤坏死因子水平(19.65±13.69)pg/mL明显更低(P=0.000;组间复发率及不良反应发生率比较,试验组复发率10.00%(χ^2=7.291,P=0.007),不良反应发生率13.33%(χ^2=5.621,P=0.018);组间临床治疗有效率比较,试验组治疗有效率93.33%(χ^2=5.037,P=0.025)。结论在小儿难治性肺炎支原体肺炎医治期间应用阿奇霉素联合头孢曲松钠治疗,患儿临床症状改善时间短,血清细胞因子水平明显改变,住院时间短,不良反应发生率及复发率低,值得临床推荐。

Objective To evaluate the efficacy and safety of azithromycin combined with ceftriaxone sodium in the treatment of refractory mycoplasma pneumonia in children.Methods 300 children with refractory mycoplasma pneumonia admitted from February 2017 to November 2018 were randomly divided into control group(azithromycin)and experimental group(azithromycin combined with ceftriaxone sodium).To observe the clinical effect of the two methods.Results Relative to the reference group,the test group had cough disappearance(3.33±0.26)d,fever time(3.85±1.52)d,pulmonary murmur disappeared(5.66±2.14)d,wheezing time(3.52±0.54)d,and hospitalization time(11.75±3.08)d significantly shortened(t=24.038,5.663,9.526,12.609,17.567,P=0.000);serum cytokine levels in the two groups of patients,interleukin-6 levels(15.56±10.43)pg/mL after intervention in the experimental group,interleukin-8(10.66±6.29)pg/mL and tumor necrosis factor level(19.65±13.69)pg/mL were significantly lower(P=0.000);group recurrence rate and incidence of adverse reactions,test group recurrence rate 10.00%(χ^2=7.291,P=0.007),the incidence of adverse reactions was 13.33%(χ^2=5.621,P=0.018);the effective rate of clinical treatment between groups was 93.33%(χ^2=5.037,P=0.025).Conclusion In the treatment of refractory pneumonia mycoplasma pneumonia in children,azithromycin combined with ceftriaxone sodium treatment,children with short clinical improvement,serum cytokine levels significantly changed,hospitalization time is short,adverse reaction rate and recurrence rate is low,it is worthy of clinical recommendation.