阿奇霉素联合头孢曲松治疗儿童支原体肺炎的临床观察

The Clinical observation of azithromycin combined with ceftriaxone on mycoplasma pneumonia in children and its effect on chemokines and lung function

目的探讨阿奇霉素联合头孢曲松治疗儿童支原体肺炎的临床效果及对趋化因子、肺功能的影响。方法于2018年1月~2020年6月收治的60例支原体肺炎患儿随机分为试验组和对照组,每组30例,试验组给予阿奇霉素联合头孢曲松治疗,对照组给予阿奇霉素治疗,两组均治疗7 d。对比两组疗效、血清趋化因子、炎症因子及肺功能差异。结果试验组治疗总有效率(86.67%)显著高于对照组(66.67%)(P<0.05);两组患者治疗前血清趋化因子MCP-4、MDC、CysLTs差异无统计学意义(P>0.05),治疗后各项指标较治疗前降低(P<0.05),且试验组低于对照组(P<0.05);两组患者治疗前血清炎症因子IL-6、IL-8差异无统计学意义(P>0.05),治疗后血清炎症因子较治疗前降低(P<0.05),且试验组低于对照组(P<0.05);两组患者治疗前肺功能指标V-T、FEV1、PEF、MMEF差异无统计学意义(P>0.05),治疗后各项指标较治疗前升高(P<0.05),且试验组高于对照组(P<0.05);两组均无严重不良反应发生。结论阿奇霉素联合头孢曲松治疗儿童支原体肺炎疗效确切,能够有效抑制炎症反应,降低趋化因子水平,改善肺功能。

Objective To explore the clinical effect of azithromycin combined with ceftriaxone in the treatment of childhood mycoplasma pneumonia and its influence on chemokines and lung function.Methods 60 patients with mycoplasma pneumonia admitted from January 2018 to June 2020 were randomly divided into experimental group and control group,with 30 cases in each group.The experimental group was treated with azithromycin combined with ceftriaxone,and the control group was treated with azithromycin.Both groups were treated for 7 days.To compare the clinical efficacy,serum chemokines,inflammatory factors and lung function in two groups.Results The total effective rate of treatment in the experimental group(86.67%)was significantly higher than control group(66.67%)(P<0.05).There was no significant difference in serum chemokines MCP-4,MDC,CysLTs before treatment between the two groups of patients(P>0.05),and various indexes after treatment were lower than before(P<0.05).All indicators of the experimental group after treatment were lower than control group(P<0.05).There was no significant difference in serum inflammatory factors IL-6,IL-8 before treatment between the two groups of patients(P>0.05),and various indexes after treatment were lower than before(P<0.05).All indicators of the experimental group after treatment were lower than control group(P<0.05).There was no significant difference in pulmonary function indexes VT,FEV1,PEF,MMEF between the two groups before treatment(P>0.05),and the indexes after treatment were higher than before treatment(P<0.05).The indexes of the experimental group after treatment were higher than control group(P<0.05).No serious adverse reactions occurred in both groups.Conclusion Azithromycin combined with ceftriaxone has a definite effect in the treatment of mycoplasma pneumonia in children,which can effectively inhibit inflammation,reduce the level of chemokines,and improve lung function and which is worthy of clinical application.