小儿肺大叶实变性重症MPP患者采用阿奇霉素联合不同剂量注射用甲泼尼龙琥珀酸钠治疗的效果

The effect of treatment with azithromycin combined with different doses of methylprednisolone sodium succinate in children with severe MPP with large lobe consolidation

目的探讨阿奇霉素联合不同剂量注射用甲泼尼龙琥珀酸钠对小儿肺大叶实变性重症肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)的治疗效果。方法选取本院2015年11月至2017年11月收治的76例小儿肺大叶实变性重症MPP患儿为研究对象,根据患儿入院顺序分为对照组和观察组,各38例。两组均用阿奇霉素治疗,对照组联合使用低剂量注射用甲泼尼龙琥珀酸钠,观察组联合使用高剂量注射用甲泼尼龙琥珀酸钠,比较两组治疗总有效率、治疗前后炎症因子水平和症状持续时间。结果观察组治疗总有效率高于对照组,症状持续时间短于对照组,差异有统计学意义(P<0.05);治疗前,两组炎症因子水平比较差异无统计学意义;治疗后,观察组白细胞介素-2水平高于对照组,白细胞介素-6和肿瘤坏死因子-α水平均低于对照组(P<0.05)。结论阿奇霉素联合高剂量注射用甲泼尼龙琥珀酸钠疗法治疗小儿肺大叶实变性重症MPP患者,可明显提升疾病治疗效果,调节炎症因子水平,缩短症状持续时间,值得临床推广应用。

Objective To investigate the therapeutic effect of azithromycin combined with different doses of methylprednisolone sodium succinate for injection on severe mycoplasma pneumoniae pneumonia(mycoplasma pneumoniae pneumonia,MPP)in children with lobar consolidation.Methods 76 pediatric patients with severe MPP with lobar consolidation admitted to our hospital from November 2015 to November 2017 were selected as the research subjects.According to the order of admission,the patients were divided into control group and observation group,with 38 cases in each group.Both groups were treated with azithromycin.The control group was combined with low-dose methylprednisolone sodium succinate for injection,and the observation group was combined with high-dose sodium methylprednisolone succinate for injection.The total effective rate of treatment,the level of inflammatory factors before and after treatment,and the duration of symptoms were compared between the two groups.Results The total effective rate of treatment in the observation group was higher than that in the control group,and the duration of symptoms was shorter than that in the control group,the difference was statistically significant(P<0.05);before treatment,the difference in the levels of inflammatory factors between the two groups was not statistically significant;after treatment,the level of interleukin-2 in the observation group was higher than that of the control group,and the levels of interleukin-6 and tumor necrosis factor-αwere lower than those of the control group(P<0.05).Conclusion The treatment of azithromycin combined with high-dose methylprednisolone sodium succinate for pediatric patients with severe MPP with lobar consolidation can significantly improve the treatment effect of the disease,adjust the level of inflammatory factors,and shorten the duration of symptoms.It is worthy of clinical application.