大剂量维生素C联合阿奇霉素对肺炎支原体感染患儿IL-6、TNF-α和CRP水平的影响

Effect of High Dose Vitamin C Combined with Azithromycin on IL-6,TNF-αand CRP Levels in Children with Mycoplasma Pneumoniae Infection

目的:探讨大剂量维生素C联合阿奇霉素治疗肺炎支原体感染的效果及对患儿白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平的影响。方法:选取2019年1-12月在本院诊治的124例肺炎支原体肺炎(MPP)患儿,按照随机数字表法将患儿分为对照组和观察组,每组62例。在对症支持治疗的基础上,对照组患儿给予阿奇霉素治疗,观察组患儿给予阿奇霉素联合大剂量维生素C治疗。比较两组患儿疗效和炎症相关指标,分析患儿体征、症状缓解情况和肺功能指标,观察患儿不良反应发生情况。结果:观察组总有效率为95.16%,明显高于对照组的77.42%,差异有统计学意义(P<0.05)。两组治疗后的IL-6、TNF-α和CRP水平均低于治疗前,且观察组上述指标水平均低于对照组,差异均有统计学意义(P<0.05)。与对照组相比,观察组患儿血常规恢复时间、咳嗽憋喘消失时间、肺部啰音消失时间和退热时间均明显缩短,差异均有统计学意义(P<0.05);两组的胸片阴影消失时间对比,差异无统计学意义(P>0.05)。治疗后,两组的FVC、PEF、FEV_(1)/FVC%水平均升高,观察组均明显高于对照组,差异均有统计学意义(P<0.05)。对照组不良反应发生率为6.45%,观察组为1.61%,两组比较差异无统计学意义(P>0.05)。结论:MPP患儿给予大剂量维生素C联合阿奇霉素治疗,效果显著,减少了炎症反应,可有效缓解临床症状和体征,改善肺功能,提升安全性。

Objective:To investigate the efficacy of high dose Vitamin C combined with Azithromycin in the treatment of mycoplasma pneumoniae infection and its influence on the levels of IL-6,TNF-αand CRP in children.Method:A total of 124 children with mycoplasma pneumoniae pneumonia(MPP)in our hospital from January to December 2019 were selected,they were divided into the control group and observation group,according to random number table method,62 cases in each group.On the basis of symptomatic supportive treatment,the control group was given Azithromycin treatment,and the observation group was treated with Azithromyzcin combined with high dose Vitamin C.The curative effect and inflammation related indexes of the two groups were compared,the signs,symptoms relief and pulmonary function indexes were analyzed,and the incidence of adverse reactions was observed.Result:The total effective rate of the observation group was 95.16%,significantly higher than 77.42%of the control group(P<0.05).The levels of IL-6,TNF-αand CRP in both groups after treatment were lower than those before treatment,and the above indexes in the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).The recovery time of blood routine,the disappearance time of cough and asthma,the disappearance time of pulmonary rales and the time of defervescence in the observation group were significantly shorter than those in the control group(P<0.05);there was no significant difference between the two groups in the disappearance time of chest shadow(P>0.05).After treatment,FVC,PEF and FEV_(1)/FVC%levels of the two groups were increased,and the observation group were significantly higher than those of the control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the control group was 6.45%,and that in the observation group was 1.61%,there was no significant difference between the two groups(P>0.05).Conclusion:The curative effect of high dose Vitamin C and Azithromycin in MPP children significantly improve,the inflammatory reaction reduce,the clinical symptoms and signs effectively relieve,the lung function improve,and the safety improve.