不同剂量甲泼尼龙在小儿肺炎支原体肺炎患儿中的应用效果

Effect of different doses of methylprednisolone in children with Mycoplasma pneumoniae pneumonia

目的:探讨不同剂量甲泼尼龙在小儿肺炎支原体肺炎患儿中的应用效果。方法:选取276例小儿肺炎支原体肺炎患儿随机分为对照组(n=92,常规对症治疗+阿奇霉素)、低剂量组[n=92,常规对症治疗+阿奇霉素+甲泼尼龙(1 mg/kg,1次/d)]和高剂量组[n=92,常规对症治疗+阿奇霉素+甲泼尼龙(2 mg/kg,1次/d)],对比两组效果。结果:低剂量组和高剂量组治疗总有效率均显著高于对照组(P<0.05),且高剂量组显著高于低剂量组(P<0.05)。低剂量组和高剂量组退热时间、咳嗽消失时间、音消失时间、肺部阴影消失时间均显著短于对照组(P<0.05),且高剂量组显著短于低剂量组(P<0.05)。经治疗3组CRP、IL-6水平均显著降低(P<0.05),且低剂量组和高剂量组显著低于对照组(P<0.05),高剂量组显著低于低剂量组(P<0.05)。三组不良反应发生率比较差异不显著(P>0.05)。结论:在常规对症治疗+阿奇霉素治疗基础上对小儿肺炎支原体肺炎患儿采用甲泼尼龙辅助治疗可有效提高治疗效果,缩短症状消失时间,不增加不良反应发生率,且高剂量甲泼尼龙疗效更佳。

Objective:To investigate the effect of different doses of methylprednisolone in children with Mycoplasma pneumoniae pneumonia.Methods:Two hundred and seventy-six children with Mycoplasma pneumoniae pneumonia were randomly divided into a control group(n=92,routine symptomatic treatment plus azithromycin),a low dosage group(n=92,routine symptomatic treatment plus azithromycin plus 1 mg/kg methylprednisolone for once a day)and a high dosage group(n=92,routine symptomatic treatment plus azithromycin plus 2 mg/kg methylprednisolone for once a day).Results:The overall response rate was significantly higher in the low dosage group and high dosage group than the control group(P<0.05),and furthermore in the high dosage group than the low dosage group(P<0.05).The times for fever-dowering and the disappearance of cough,rale and lung shadow were significantly shorter in the low dosage group and the high dosage group than the control group,and furthermore in the high dosage group than the low dosage group(P<0.05).The levels of CRP and IL-6 in the three groups were significantly decreased(P<0.05),and were significantly lower in the low dosage group and the high dosage group than the control group(P<0.05),and furthermore in the high dosage group than the low dosage group(P<0.05).There were no significant differences in the incidence of adverse reactions among the three groups(P>0.05).Conclusion:On the basis of routine symptomatic treatment and azithromycin treatment,methylprednisolone adjuvant treatment for children with Mycoplasma pneumoniae pneumonia can effectively improve the therapeutic effect,shorten the symptom disappearance time,do not increase the incidence of adverse reactions,and the high dosage methylprednisolone is more effective.