糖皮质激素辅助治疗儿童肺炎支原体大叶性肺炎的临床疗效

Clinical effect of glucocorticoid in adjuvant treatment of mycoplasma pneumoniae lobar pneumonia in children

目的观察糖皮质激素辅助治疗儿童肺炎支原体大叶性肺炎的临床疗效。方法选取2017年1月-2019年1月于安徽省蚌埠市第一人民医院儿科就诊并住院治疗的肺炎支原体大叶性肺炎患儿52例,采用随机数字表法分为观察组(n=26)和对照组(n=26)。对照组给予红霉素及对症治疗,观察组在对照组治疗的基础上采用糖皮质激素(甲泼尼龙)治疗。比较2组患儿临床疗效、治疗前后炎性指标及不良反应。结果观察组患儿治疗总有效率为96.15%,高于对照组的76.92%(χ^(2)=4.127,P=0.042)。治疗后,2组患儿红细胞沉降率(ESR)、C反应蛋白(CRP)、白细胞计数(WBC)和降钙素原(PCT)水平均低于治疗前,且观察组低于对照组(P<0.01)。观察组患儿在治疗过程中均未发现皮疹、面部潮红、心率加快、腹痛等严重不良反应;对照组患儿有1例出现轻微的腹痛现象,停药后腹痛消失,不良反应发生率为3.85%(1/26)。结论糖皮质激素辅助治疗儿童肺炎支原体大叶性肺炎可提高临床效果,减轻炎性反应,并且不良反应少,可促进患儿的康复。

Objective To observe the clinical efficacy of glucocorticoids in adjuvant treatment of mycoplasma pneumoniae lobar pneumonia in children.Methods Selected 52 children with mycoplasma pneumoniae lobar pneumonia who were treated in the Department of Pediatrics,Bengbu First People’s Hospital,Anhui Province from January 2017 to January 2019.Using random number table method,they were divided into observation group(n=26)and control group(n=26).The control group was given erythromycin and symptomatic treatment,and the observation group was treated with glucocorticoid(methylprednisolone)on the basis of the treatment of the control group.The clinical efficacy,inflammatory indexes before and after treatment and adverse reactions were compared between the two groups.Results The total effective rate of treatment for children in the observation group was 96.15%,which was higher than 76.92%in the control group(χ^(2)=4.127,P=0.042).After treatment,the erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),white blood cell count(WBC)and procalcitonin(PCT)levels of the two groups were lower than before treatment,and the observation group was lower than the control group(P<0.01).During the treatment,no children in the observation group found serious adverse reactions such as skin rash,facial flushing,rapid heart rate,abdominal pain,etc.;in the control group,one child had mild abdominal pain,and the abdominal pain disappeared after stopping the drug.The adverse reaction rate was 3.85%(1/26).Conclusion Glucocorticoid in adjuvant treatment of mycoplasma pneumoniae lobar pneumonia in children can improve the clinical effect,reduce the inflammatory reaction,and have fewer adverse reactions,which can promote the recovery of children.