普米克令舒联合抗生素序贯治疗小儿支原体肺炎的临床研究

Clinical study on sequential therapy of mycoplasma pneumonia with primicort combined with antibiotics

目的探讨普米克令舒雾化吸入联合红霉素与阿奇霉素序贯治疗支原体肺炎患儿的疗效及其对炎性因子和细胞免疫指标的影响。方法选取122例支原体肺炎患儿,随机分为2组,各61例。对照组给予红霉素与阿奇霉素序贯治疗,试验组在对照组治疗的基础上给予普米克令舒雾化吸入治疗,对比2组患儿的临床疗效、临床症状消失时间、临床症状评分、血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-2(IL-2)水平及免疫功能指标变化情况。结果试验组临床疗效较好(P<0.05);试验组症状消失时间显著缩短(P<0.05);2组治疗后喘息、咳嗽、高热的症状评分显著降低(P<0.05),且试验组降低更明显(P<0.05);2组患儿CD4+和CD4+/CD8+水平显著升高,CD8+水平显著降低(P<0.05),且试验组变化更明显(P<0.05);2组治疗后血清TNF-α、IL-2和CRP水平明显降低(P<0.05),且试验组降低更明显(P<0.05)。结论普米克令舒雾化吸入联合红霉素与阿奇霉素序贯治疗支原体肺炎患儿疗效较好,能降低血清TNF-α、IL-2和CRP水平。

Objective To investigate the therapeutic effect of atomized inhalation of primicort combined with erythromycin and azithromycin in sequential treatment of children with mycoplasma pneumonia and its effect on inflammatory factors and cellular immune indexes.Methods A total of 122 children with mycoplasma pneumonia were randomly divided into 2 groups,with 61 cases in each.The control group were treated with erythromycin and azithromycin sequentially,while the experimental group were treated with primicort atomization inhalation on the basis of the control group.The clinical efficacy,disappearance time of clinical symptoms,clinical symptom score,serum C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-2(IL-2)levels and immune function indexes of the 2 groups were compared.Results Compared with control group,the total effective rate of experimental group was better(P<0.05),and the disappearance time of clinical symptoms was significantly shorter(P<0.05).After treatment,the symptoms of wheezing,cough and high fever in both groups were significantly reduced(P<0.05).In the experimental group,the decrease was more significant(P<0.05).The levels of CD4+and CD4+/CD8+in both groups were significantly increased,while the levels of CD8+were significantly decreased(P<0.05).The improvement of the experimental group was significant(P<0.05).The serum levels of TNF-α,IL-2 and CRP in the 2 groups were significantly decreased after treatment(P<0.05).In addition,the reduction in the experimental group was significant(P<0.05).Conclusion The sequential treatment of children with mycoplasma pneumonia by nebulized inhalation of primicort combined with erythromycin and azithromycin has a good therapeutic effect,which can reduce the serum levels of TNF-α,IL-2 and CRP.