维生素D联合阿奇霉素序贯疗法对支原体肺炎的效果

Effect of vitamin D combined with azithromycin sequential therapy on mycoplasma pneumonia

目的探究维生素D联合阿奇霉素序贯疗法对支原体肺炎(MPP)患儿抑制性卡巴蛋白-α(IκB-α)、白细胞介素-3(IL-3)水平的影响。方法选取MMP患儿(<12周岁)117例,随机分为观察组(57例)和对照组(60例),对照组患儿给予阿奇霉素治疗,观察组在对照组治疗的基础上加用维生素D。治疗4周,观察2组的临床疗效、肺功能、炎性因子与IκB-α水平、T细胞亚群、凝血功能和临床症状消失时间及不良反应。结果治疗后观察组总有效率(96.49%)高于对照组(83.33%),差异有统计学意义(P<0.05)。观察组用力肺活量占预计值百分比(FVC%)、用力呼气肺活量1秒量占预计值百分比(FEV1%)、FEV1/FVC均高于对照组(P<0.05)。观察组超敏C反应蛋白(Hs-CRP)、肿瘤坏死因子-α(TNF-α)和IκB-α低于对照组,肺表面活性蛋白(SP-A)和IL-3高于对照组(P<0.05)。观察组CD4+、CD4+/CD8+高于对照组,CD8+低于对照组(P<0.05)。观察组血浆凝血酶原时间(PT)、凝血酶时间(TT)和活化部分凝血酶时间(APTT)高于对照组,纤维蛋白原(FIB)低于对照组(P<0.05)。观察组体温恢复时间、啰音消失时间和咳嗽好转时间均短于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论维生素D联合阿奇霉素序贯疗法治疗MPP患儿疗效较好,在改善肺功能、炎性反应、IκB-α和凝血因子水平方面具有积极作用,能调节T细胞亚群,加快临床症状消失,且不良反应较小。

Objective To explore the effect of vitamin D combined with azithromycin sequential therapy on the levels of inhibitory kappa protein-α(IκB-α)and interleukin-3(IL-3)in children with mycoplasma pneumonia.Methods A total of 117 children with mycoplasma pneumonia(less than 12 years old)were randomly divided into observation group(57 cases)and control group(60 cases).The control group received azithromycin treatment,and the observation group was supplemented with vitamin D on the basis of the control group.After 4 weeks of treatment,the clinical efficacy,lung function,inflammatory factors and IκB-αlevels,T cell subsets,coagulation function,disappearance time of clinical symptoms,and adverse reactions were observed in the 2 groups.Results The total effective rate of the observation group was higher than that of the control group(96.49%vs 83.33%,P<0.05).The percentage of forced expiratory vital capacity in the predicted value(FVC%),the percentage of forced expiratory volume 1 second in the predicted value(FEV1%),and the FEV1/FVC ratio were higher in observation group than in control group(P<0.05).In the observation group,hypersensitivity C-reactive protein(Hs-CRP),tumor necrosis factor-α(TNF-α),and IκB-αwere lower than those in the control group,while the pulmonary surfactant protein(SP-A)and IL-3 were higher than those in the control group(P<0.05).CD4+and CD4+/CD8+in the observation group were higher than those in the control group,and CD8+was lower than the control group(P<0.05).The plasma prothrombin time(PT),thrombin time(TT)and activated partial thrombin time(APTT)were higher in observation group than in control group,and fibrinogen(FIB)was lower than the control group(P<0.05).The body temperature recovery time,rale disappearance time,and cough improvement time of the observation group were shorter than those of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the 2 groups(P>0.05).Conclusion Vitamin D combined with azithromycin sequential therapy is effective in the treatment of children with mycoplasma pneumonia,which can significantly improve the lung function,inflammatory factors,IκB-αand blood coagulation function,regulate the T cell subsets,and shorten the disappearance time of clinical symptoms with few adverse reactions.