糖皮质激素联合阿奇霉素治疗儿童难治性支原体肺炎的疗效及对血清细胞因子的影响

Effect of Glucocorticoid Combined with Azithromycin in the Treatment of Refractory Mycoplasma Pneumonia in Children and Its Influence on Serum Cytokines

目的:观察糖皮质激素联合阿奇霉素治疗儿童难治性支原体肺炎的临床效果及对血清细胞因子的影响。方法:将我院2018年1月—2020年2月收治的120例难治性支原体肺炎患儿分为观察组和对照组,两组各60例。对照组在常规对症治疗基础上应用阿奇霉素序贯治疗,观察组在对照组用药基础上加用甲泼尼龙琥珀酸钠注射治疗,观察两组临床表现改善情况,比较治疗前后血清细胞因子水平。结果:观察组体温恢复正常耗时、咳嗽消退耗时、肺部湿罗音消失耗时均短于对照组,IL-10、TNF-α水平明显低于对照组,IL-2、CD4^+淋巴细胞、IFN-γ水平显著高于对照组,差异均存在统计学意义(P<0.05)。结论:糖皮质激素联合阿奇霉素治疗儿童难治性支原体肺炎,能有效改善临床症状,减轻炎症反应,提高临床疗效。

Objective:To observe the clinical effect of glucocorticoid combined with azithromycin in the treatment of children with refractory Mycoplasma pneumonia and its influence on serum cytokines.Methods:120 cases of refractory Mycoplasma pneumonia in our hospital from January 2018 to February 2020 were divided into observation group and control group,60 cases in each group.The control group was given Azithromycin Sequential Treatment on the basis of conventional symptomatic treatment,and the observation group was treated with methylprednisolone sodium succinate injection on the basis of conventional symptomatic treatment.The improvement of clinical manifestations of the two groups was observed,and serum cytokine levels before and after treatment were compared.Results:The time taken for the body temperature to return to normal,the time for cough to subside and the time for lung moist rales to disappear in the observation group were shorter than those in the control group,the levels of IL-10 and TNF-αwere significantly lower than those in the control group,and the levels of IL-2,CD4+lymphocytes and IFN-γwere significantly higher than those in the control group(P<0.05).Conclusion:Glucocorticoid combined with azithromycin in the treatment of refractory Mycoplasma pneumonia in children can effectively improve the clinical symptoms,reduce the inflammatory reaction and improve the clinical efficacy.