阿奇霉素和红霉素对小儿支原体肺炎相关炎症介质及免疫调节状态的效果对比

Comparison of Effects of Azithromycin and Erythromycin on Related Inflammatory Mediators and Immunoregulation Status of Children with Mycoplasma Pneumonia

目的比较分析阿奇霉素和红霉素对小儿支原体肺炎炎症介质及免疫调节状态的效果。方法选取2016年6月至2018年6月于东莞市妇幼保健院儿科确诊支原体肺炎的320例患儿为研究对象,按随机数字表法分为阿奇霉素组和红霉素组,每组各160例。两组均给予常规治疗,阿奇霉素组予以口服阿奇霉素治疗,红霉素组给予红霉素滴注治疗,比较两组临床疗效,血清肿瘤坏死因子-α(TNF-α)、白介素-10(IL-10)、免疫球蛋白(IgA、IgM)、补体(C_(3)、C_(4))水平及以不良反应发生情况。结果阿奇霉素组治疗总有效率显著高于红霉素组(P<0.05),两组治疗后TNF-α、IL-10、C_(3)、C_(4)水平显著低于治疗前(P<0.05),且阿奇霉素组治疗后TNF-α、IL-10、C_(3)、C_(4)水平显著低于红霉素组(P<0.05),两组治疗后IgA、IgM水平显著高于治疗前(P<0.05),且阿奇霉素组治疗后IgA、IgM水平显著高于红霉素组(P<0.05),阿奇霉素组不良反应发生率显著低于红霉素组(P<0.05)。结论阿奇霉素治疗小儿支原体肺炎疗效显著,可改善患儿血清炎症介质水平,调节患儿免疫状态。

Objective To study and compare the effects of azithromycin and erythromycin on inflammatory mediators and immunoregulation status of mycoplasma pneumonia in children.Methods A total of 320 children who were diagnosed as mycoplasma pneumonia in pediatric department of Dongguan Maternal and Child Health Hospital from June 2016 to June 2018 were selected as research objects.According to the random number table method,they were divided into the azithromycin group(n=160)and the erythromycin group(n=160).Two groups were both given routine treatment.The azithromycin group was given orally azithromycin treatment while the control group was given erythromycin drip.Clinical curative effects,serum tumor necrosis factor-α(TNF-α)level,interleukin-10(IL-10)level,immunoglobulin(IgA/IgM)level,complement(C_(3) and C_(4))level and adverse reactions were compared between two groups.Results Total effective rate of the azithromycin group was significantly higher than that of the erythromycin group(P<0.05).Level of TNF-α,IL-10,IgA,IgM,C_(3) and C_(4) of two group after treatment was significantly lower than those before treatment(P<0.05).Level of TNF-α,IL-10,C_(3) and C_(4) in azithromycin group was significantly lower than that in the erythromycin group(P<0.05).Levels of IgA and IgM after treatment in two groups were both higher than those before treatment(P<0.05).Levels of IgA and IgM of azithromycin group were significantly higher than those in the erythromycin group(P<0.05).The incidence of adverse reactions in azithromycin group was significantly lower than that in the erythromycin group(P<0.05).Conclusion Azithromycin in treatment of children with mycoplasma pneumonia has significant curative effects,which can significantly improve the level of serum inflammatory mediators and regulate the immune status of children.