阿奇霉素与多西环素治疗恙虫病合并中毒性肝炎疗效比较

Azithromyclin versus doxycycline for the treatment of scrub typhus combined with toxic hepatitis

目的比较阿奇霉素与多西环素治疗恙虫病合并中毒性肝炎的临床效果。方法回顾性分析宿迁市第一人民医院2016年1月-2019年12月收治的87例恙虫病合并中毒性肝炎患者的临床资料,根据初始用药分为阿奇霉素组47例和多西环素组40例,比较两组患者治疗的有效性及安全性。结果阿奇霉素组的退热时间(42.3±19.5)h与多西环素组的退热时间(40.5±24.1)h相比,差异无统计学意义(P=0.714);两组的72 h退热率比较差异无统计学意义(91.5%vs.90.0%,P=1.000);两组治疗结束时肝功能复常率比较差异无统计学意义(76.6%vs.75.0%,P=0.491);阿奇霉素组不良反应发生率为19.1%,明显低于多西环素组的37.5%,两组比较差异有统计学意义(P<0.05)。结论阿奇霉素与多西环素治疗恙虫病合并中毒性肝炎安全有效,阿奇霉素组不良反应发生率更低。

Objective To compare the efficacy and safety of azithromycin with doxycycline for the treatment of scrub typhus combined with toxic hepatitis.Methods A retrospective analysis was conducted in 87 patients from January 2016 to December 2019 in our hospital;of whom,47 were assigned to azithromycin-treated group and 40 to doxycycline-treated group according to initial treatment regimens.The time to defervescence,the defervescence rate within 72 hours,the rate of liver function recovery and adverse events were compared.Results The time to defervescence was(42.3±19.5)hours for the azithromycin-treated group and(40.5±24.1)hours for the doxycycline-treated group(P=0.714);the defervescence rate within 72 hours was 91.5% in the azithromycin-treated group and 90.0% in the doxycycline-treated group(P=1.000);the rate of liver function recovery was 76.6% in the azithromycin-treated group and 75.0% in the doxycycline-treated group(P=0.491);the azithromycin-treated group had adverse events of the individual cases significantly less than that of the doxycycline-treated group(19.1% vs.37.5%),the difference was statistically significant(P<0.05).Conclusion Azithromycin was as effective and safe as doxycycline in treatment of scrub typhus combined with toxic hepatitis,and azithromycin had lower frequency of adverse effects.